Prevalence and clinical correlation of hepatitis E virus antibody in the patients’ serum samples from a tertiary care hospital in Thailand during 2015–2018

Abstract

Background Prevalence and incidence of hepatitis caused by HEV infection are usually higher in developing countries. This study demonstrated the HEV seroprevalence and incidence of HEV infection in patients with clinical hepatitis in a tertiary hospital in Thailand. Methods A laboratory-based cross-sectional study was conducted using 1106 serum samples from patients suspected of HEV infection sent to the Serology laboratory, Siriraj Hospital, for detecting HEV antibodies during 2015–2018. Prevalence of anti-HEV IgG and IgM antibodies in general patients, including organ transplant recipients and pregnant women in a hospital setting, were determined using indirect enzyme-linked immunosorbent assay (ELISA) kits. Comparison of laboratory data between groups with different HEV serological statuses was performed. Results HEV IgG antibodies were detected in 40.82% of 904 serum samples, while HEV IgM antibodies were detected in 11.75% of 1081 serum samples. Similar IgG and IgM antibody detection rates were found in pregnant women. Interestingly, anti-HEV IgM antibodies were detected in 38.5% of patients who underwent organ transplantation. Patients who tested positive for anti-HEV IgM antibodies had higher alanine aminotransferase levels than those who had not. In contrast, patients who tested positive for anti-HEV IgG had more elevated levels of total bilirubin than those who tested negative. Conclusions HEV seroprevalence and incidence in patients with clinical hepatitis were relatively high in the Thai population, including the pregnancy and organ transplant subgroups. The results potentially benefit the clinicians in decision-making to investigate HEV antibodies and facilitating proper management for patients.

Prevalence of Hepatitis E Virus and Its Associated Outcomes among Pregnant Women in China

“…It is worth noting that there were only 18 pregnant women aged ≤19 years in this study, with the majority of pregnant women aged 20–29 years. The anti-HEV IgM-positive rate was not affected by age in the present study, differing from findings in previous studies [ 19 , 33 ]. Previous studies concerning the prevalence of HEV were primarily performed based on anti-HEV antibodies [ 4 , 19 , 21 , 22 , 24 , 29 , 31 , 33 ].…”

“…The anti-HEV IgM-positive rate was not affected by age in the present study, differing from findings in previous studies [ 19 , 33 ]. Previous studies concerning the prevalence of HEV were primarily performed based on anti-HEV antibodies [ 4 , 19 , 21 , 22 , 24 , 29 , 31 , 33 ]. In this study, all pregnant women were also tested for HEV antigen and HEV RNA.…”

Fetal Loss in Pregnant Rabbits Infected with Genotype 3 Hepatitis E Virus Is Associated with Altered Inflammatory Responses, Enhanced Virus Replication, and Extrahepatic Virus Dissemination with Positive Correlations with Increased Estradiol Level

“…Serum total bilirubin is a common marker of liver function, and a high level of blood TBB is indicative of liver injury ( 84 ). HEV-infected patients had elevated levels of TBB compared to uninfected ones ( 20 ). In the present study, we found that serum levels of TBB in HEV-infected pregnant rabbits were higher than those in HEV-infected nonpregnant rabbits and uninfected pregnant rabbits.…”

“…In pregnant women, adverse effects of HEV-1 infection include vertical virus transmission of >30%, preterm delivery, miscarriage, stillbirth (an estimate of 3,000 cases annually), and fulminant hepatic failure (FHF), with a mortality rate of up to 30% ( 2 , 13 – 17 ). Recent reports from several countries, including Nigeria ( 18 ), Senegal ( 19 ), Thailand ( 20 ), Egypt ( 21 ), and Argentina ( 22 ), showed that HEV infections in pregnant women continue to be a more significant clinical problem than in nonpregnant women and immunocompetent individuals. Among the hepatotropic viruses, the high mortality in pregnant women is unique to HEV, and therefore, there is a critical need for an appropriate animal model to delineate the underlying mechanisms of HEV-induced adverse outcomes during pregnancy.…”

A Comparison of Clinical Manifestations and Outcomes between Acute Sporadic Hepatitis A and Hepatitis E Infections in Thailand

“…Subsequent years showed a decreasing trend: 49.01% in 2016, 37.68% in 2017, and 26.04% in 2018 in the same population. It is notable that the seroprevalence of HEV demonstrated an increase with advancing age groups [ 31 ]. The decline in the seroprevalence of both HAV and HEV might be due to improved hygiene in Thailand.…”