Hepatitis E Virus Seroprevalence among Adults, Germany

Faber, Mirko; Wenzel, Jürgen J.; Jilg, Wolfgang; Thamm, Michael; Höhle, Michael; Stark, Klaus

doi:10.3201/eid1810.111756

Cited by 158 publications

(163 citation statements)

References 15 publications

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“…The data on HEV seroprevalence gained by different testing approaches are demanding for analysis although in general our results may be comparable with others [10,13,20,22,[29][30][31][32][33]. There is a high probability that our patients were HEV infected in Croatia since there is no recognition of their recent travel to endemic regions and all HEV RNA determined were genotype 3 that was documented in swine although a direct connection of viral transmission cannot be defined.…”

Section: Discussionsupporting

confidence: 52%

Hepatitis E in patients with hepatic disorders and HIV-infected patients in Croatia: is one diagnostic method enough for hepatitis E diagnosis?

Rode

Jemeršić

Brnić

et al. 2014

Eur J Clin Microbiol Infect Dis

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Section: Discussionsupporting

confidence: 52%

Hepatitis E in patients with hepatic disorders and HIV-infected patients in Croatia: is one diagnostic method enough for hepatitis E diagnosis?

Rode

Jemeršić

Brnić

et al. 2014

Eur J Clin Microbiol Infect Dis

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“…These differences could be due to sharing syringes, environmental and socioeconomic variations as well as differences in level of hygiene, safe water sources and sewage disposal systems in these studied populations. Seroprevalence rates of HEV among blood donors were 1.2%, 16.8% and 27% in the USA, Germany and the Netherlands, respectively (28)(29)(30); however, Iran is in an endemic area with a rate of more than 5% regarding the seroprevalence of HEV (5,(7)(8)(9). The most common transmission route of HEV infection is fecal-oral through contaminated foods and water; thus, high sanitation, public health and personal hygiene can prevent transmission of HEV infection in endemic areas (1)(2)(3).…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of Hepatitis E Virus Among Injection Drug Users and Non-Injection Drug Users in Hamadan, West of Iran

Keramat¹,

Mamani²,

Samadi³

et al. 2014

Avicenna J Clin Microbiol Infect

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Background: Hepatitis E virus (HEV) infection is a self-limited hepatitis and the most common cause of acute adult hepatitis in Asia. Young adults and middle-aged populations are more likely to be infected than other age groups. Objectives: The aim of this study was to determine the seroprevalence of anti-HEV among injection drug users (IDUs) compared to nonIDUs. Patients and Methods:This was a cross-sectional study performed on 131 IDUs referred to Farshchian Hospital, Hamadan, Iran and 131 nonIDUs selected from healthy visitors between March 2011 and March 2012. Anti-HEV IgG was measured in serum by ELISA method (DiaPro, Milan, Italy). Data including age, gender, education, location and duration of injection drug used were collected using a questionnaire. Results: In this study, the seroprevalence of hepatitis E virus antibody among IDUs group was 6.1%, and 1.5% among non-IDU group (Odds Ratio = 5.48; CI = 1/069-22/84), indicating that injection drug users were almost five and a half times more than non-IDUs at risk of HEV infection (P = 0.053). There was no significant association between seroprevalence of hepatitis E virus and education level (P = 0.46), duration of injection (P = 0.38) and location (P = 0.19). Conclusions: Seroprevalence of hepatitis E virus among IDUs group was higher than non-IDU group, which might be due to possible blood transmission of HEV among IDUs.

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“…(4) We used broadly binding primers and probe to ensure the detection of both zoonotic genotypes HEV-3 and HEV-4, but our ad-hoc investigation did not point at dairy cows to act as such a virus reservoir. Although infections with HEV-4 have been reported more frequently in the last years, (5) HEV-3 is the predominant zoonotic genotype in Europe.…”

Section: To the Editormentioning

confidence: 99%

No evidence for zoonotic hepatitis E virus infection through dairy milk in Germany

Baechlein

Becher

2016

Hepatology

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confounding. We find it unlikely that residual confounding can account for our relative risk estimate of 1.36.(1) Without confounder adjustment the hazard ratio was 1.50 (95% confidence interval 1.12-1.99), so the confounders we adjusted for were actually not strong confounders. This is also evident from the fact that the PPI users and nonusers were very similar, as shown in our article's Table 1. We disagree with Dr. Ali Khan's statement that in observational epidemiology relative risks below 2 are generally due to bias. We find that the review by Sørensen et al. offers a more balanced view of the pros and cons of observational and randomized studies.(2) Despite our differences of opinion, we agree with Dr. Ali Khan and colleagues on the most important and self-evident aspect: patients with a valid indication for PPIs can use them; others should not. Such practice would probably spare patients from many hepatic encephalopathy episodes, and any risk of hepatic encephalopathy attributable to PPI use would at least be countered by beneficial effects of PPIs. When we accomplish this, we can consider how to handle the excess hepatic encephalopathy risk for those patients who need PPIs. We have no evidence base for this situation, but it is a possibility that lactulose could be preemptively coadministered together with PPIs.(3) The way to obtain an evidence base seems to be a randomized PPI discontinuation trial for cirrhosis patients with a valid indication for PPIs. We believe that such a trial should be undertaken.

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Hepatitis E Virus Seroprevalence among Adults, Germany

Cited by 158 publications

References 15 publications

Hepatitis E in patients with hepatic disorders and HIV-infected patients in Croatia: is one diagnostic method enough for hepatitis E diagnosis?

Hepatitis E in patients with hepatic disorders and HIV-infected patients in Croatia: is one diagnostic method enough for hepatitis E diagnosis?

Seroprevalence of Hepatitis E Virus Among Injection Drug Users and Non-Injection Drug Users in Hamadan, West of Iran

No evidence for zoonotic hepatitis E virus infection through dairy milk in Germany

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