Hepatitis E virus infections in HIV-infected patients in Ghana and Cameroon

Feldt, Torsten; Sarfo, Fred Stephen; Zoufaly, Alexander; Phillips, Richard Odame; Burchard, Gerd‐Dieter; Lunzen, Jan van; Jochum, Johannes; Chadwick, David; Awasom, Charles; Claussen, Lisa; Drosten, Christian; Drexler, Jan Felix; Eis‐Hübinger, Anna Maria

doi:10.1016/j.jcv.2013.05.004

Cited by 50 publications

(44 citation statements)

References 39 publications

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“…We also discuss studies of sporadic cases and outbreaks of NANB hepatitis viruses in the Discussion Section with tables of data in the Additional file 1. The present paper includes studies from 28 (50%) of 56 African countries: Algeria [26-28], Burkina Faso [29], Burundi [30,31], Cameroon [32], Central African Republic [33,34], Chad [27,28,35-38], Côte d’Ivoire [39], Democratic Republic of the Congo [40], Djibouti [41,42], Ethiopia [6,43], Eritrea [44], Egypt [45-71], Gabon [72,73], Ghana [32,74-78], Kenya [79,80], Madagascar [81], Mayotte [82], Morocco [83-85], Namibia [86-88], Nigeria [89-91], Senegal [92,93], Somalia [94-96], South Africa [97,98], South Sudan [99], Sudan [35,100-105], Tunisia [106-111], the United Republic of Tanzania [112-114], and Zambia [115]. …”

Section: Methodsmentioning

confidence: 99%

A systematic review of the epidemiology of hepatitis E virus in Africa

et al. 2014

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BackgroundHepatitis E Virus (HEV) infection is a newly recognized serious threat to global public health and Africa is suspected to be among the most severely affected regions in the world. Understanding HEV epidemiology in Africa will expedite the implementation of evidence-based control policies aimed at preventing the spread of HEV including policies for the use of available resources such as HEV vaccines.MethodsHere we present a comprehensive review of HEV epidemiology in Africa based on published data. We searched for articles on HEV epidemiology in Africa from online databases such as PubMed, Scopus, and ISI Web of Science and critically reviewed appropriate publications to extract consistent findings, identify knowledge gaps, and suggest future studies.ResultsTaking a particularly high toll in pregnant women and their fetuses, HEV has infected human populations in 28 of 56 African countries. Since 1979, 17 HEV outbreaks have been reported about once every other year from Africa causing a reported 35,300 cases with 650 deaths.ConclusionsIn Africa, HEV infection is not new, is widespread, and the number of reported outbreaks are likely a significant underestimate. The authors suggest that this is a continent-wide public health problem that deserves the attention of local, regional and international agencies to implement control policies that can save numerous lives, especially those of pregnant women and their fetuses.

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Section: Methodsmentioning

confidence: 99%

A systematic review of the epidemiology of hepatitis E virus in Africa

et al. 2014

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“…A large, retrospective analysis of serum samples from HIVpositive adults and children in Cameroon and Ghana (n ϭ 1,544 total) detected high anti-HEV IgG seroprevalence, especially in Ghanaian adults (45.3%), with lower prevalence in Cameroonian adults (14.2%) and children (2.0%) (324). Although no HEV RNA was detected in any of the samples, the high seroprevalence indicates substantial exposure to the virus in this population.…”

Section: Immunosuppression and Impaired Viral Clearancementioning

confidence: 92%

Host Immune Status and Response to Hepatitis E Virus Infection

2014

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SUMMARY Hepatitis E virus (HEV), identified over 30 years ago, remains a serious threat to life, health, and productivity in developing countries where access to clean water is limited. Recognition that HEV also circulates as a zoonotic and food-borne pathogen in developed countries is more recent. Even without treatment, most cases of HEV-related acute viral hepatitis (with or without jaundice) resolve within 1 to 2 months. However, HEV sometimes leads to acute liver failure, chronic infection, or extrahepatic symptoms. The mechanisms of pathogenesis appear to be substantially immune mediated. This review covers the epidemiology of HEV infection worldwide, the humoral and cellular immune responses to HEV, and the persistence and protection of antibodies produced in response to both natural infection and vaccines. We focus on the contributions of altered immune states (associated with pregnancy, human immunodeficiency virus [HIV], and immunosuppressive agents used in cancer and transplant medicine) to the elevated risks of chronic infection (in immunosuppressed/immunocompromised patients) and acute liver failure and mortality (among pregnant women). We conclude by discussing outstanding questions about the immune response to HEV and interactions with hormones and comorbid conditions. These questions take on heightened importance now that a vaccine is available.

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“…In this setting, HEV infection may become chronic and rapidly evolve to cirrhosis [3,4]. Several cross-sectional studies have reported prevalence figures of HEV seropositivity in HIV-infected patients ranging from 1.5% in Paris to 45.3% in Ghana [5][6][7][8][9][10]. Studies including a HIV-seronegative control population [5,10] did not find differences in the rate of HEVexposure between HIV-infected patients and controls.…”

Section: Introductionmentioning

confidence: 99%

“…Few patients with positive HEV serology show detectable plasma HEV-RNA [6,7,10,11], which suggests that chronic HEV infection is uncommon, but the precise rate of evolution to chronic hepatitis E remains unclear. Few patients with positive HEV serology show detectable plasma HEV-RNA [6,7,10,11], which suggests that chronic HEV infection is uncommon, but the precise rate of evolution to chronic hepatitis E remains unclear.…”

Section: Introductionmentioning

confidence: 99%