Prevalence of Antibodies to Hepatitis E Virus in Immigrants: A Seroepidemiological Survey in the District of Foggia (Apulia‐Southern Italy)

Abstract

Hepatitis E virus (HEV) is the etiologic agent of endemically transmitted viral hepatitis. HEV is endemic in developing countries where it occurs in sporadic and endemic forms, but autochthonous sporadic cases of hepatitis E have been reported in North America and in Europe, including Italy. The aim of the present study was to assess the seroprevalence of antibodies to HEV in immigrants from developing countries to the province of Foggia. The seroprevalence of HEV was determined in a cohort of 412 immigrants (mostly from countries in sub-Saharan Africa) who had arrived recently in Italy. Serum samples were tested for anti-HEV by a commercial enzyme immunoassay (EIA) based on recombinant proteins; positive results were confirmed by a Western blot assay (Recomblot HEV). A total of 88 (21.3%) of the 412 serum samples examined were reactive to IgG anti-HEV. Eighty-one of these samples (19.7%) were confirmed by Western blot. Anti-HEV IgM was found in 34/81 subjects (41.9%) of the anti-HEV IgG positive serum samples. Almost all anti-HEV positive subjects were asymptomatic clinically, but alanine aminotransferase serum values were elevated in 28/34 (82.3%) patients with IgM anti-HEV-positive. The results of this study indicate high circulation of HEV in the immigrant population. The high prevalence of acute hepatitis involved mainly subjects who arrived in Italy during the same period from the same countries (Eritrea, Ethiopia, and Somalia).

Epidemiology of Hepatitis E Virus in China: Results from the Third National Viral Hepatitis Prevalence Survey, 2005–2006

“…The seroprevalence of HEV in a population generally increases with age [15]–[18], [22], [25]. In our study, the seroprevalence of HEV increased throughout the whole age range, the first marked increase in seropositivity occurred at 15 to 29 years in males and 20 to 39 years in females.…”

Seroprevalence of Hepatitis E Among Boston Area Travelers, 2009–2010

“…8,9 Studies from Spain and Italy have also found that immigrants from highly endemic countries have a higher prevalence of anti-HEV IgG compared with the general population. 10,11 In a case-control study of blood donors from California, donors with anti-HEV IgG were more likely than those without antibodies to report history of travel to highly endemic areas. 12 As HEV infection can have severe consequences for travelers who are pregnant or immunocompromised, it is important to identify factors associated with HEV infection.…”

The Emergence of Hepatitis E Virus in Europe

“…Intravenous drug users, hemodialysis patients and immigrants are risk factors for infection in Italy [154][155][156]158,180]. Likewise, Cacciola et al reported that 6% of cryptogenic acute hepatitis cases were caused by HEV in Southern Italy [153].…”