Racial differences in seroprevalence of HAV and HEV in blood donors in the Western Cape, South Africa: a clue to the predominant HEV genotype?

Lopes, Tatum; Cable, Russell; Pistorius, Charlotte; Maponga, Tongai; Ijaz, Samreen; Preiser, Wolfgang; Tedder, Richard S.; Andersson, Monique

doi:10.1017/s0950268817000565

Cited by 13 publications

(14 citation statements)

References 12 publications

(13 reference statements)

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“…The association of HEV seropositivity with age observed in our study has also been reported by others [7][8][9][10][11][12][13][14][15][16][17][18][19][20] and may be explained not only by the cumulative lifetime exposure to HEV, but also by cohort effect, where certain population groups were more likely to be exposed to the virus during their life.…”

Section: Epidemiology and Infectionsupporting

confidence: 90%

“…Human HEV infection, investigated using seroprevalence studies, was found to be more prevalent in older ages [7][8][9][10][11][12][13][14][15][16][17][18][19][20], lower socio-economic status [21], poorer residence areas [9,[14][15], among sheltered homeless adults [22] or uneducated people [14], specific nationalities (for example, higher in mixed race donors and ethnic groups within China [12,15], or in immigrants from Afghanistan [14]), drinking water from wells or rivers [15], consumption of meat products [7,15,17,23] especially pork [24,25] and following blood transfusions [1].…”

Section: Introductionmentioning

confidence: 99%

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Seroprevalence of hepatitis E virus in dromedary camels, Bedouins, Muslim Arabs and Jews in Israel, 2009–2017

et al. 2019

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Hepatitis E virus (HEV) is an emerging cause of viral hepatitis worldwide. Recently, HEV-7 has been shown to infect camels and humans. We studied HEV seroprevalence in dromedary camels and among Bedouins, Arabs (Muslims, none-Bedouins) and Jews and assessed factors associated with anti-HEV seropositivity. Serum samples from dromedary camels (n = 86) were used to determine camel anti-HEV IgG and HEV RNA positivity. Human samples collected between 2009 and 2016 from >20 years old Bedouins (n = 305), non-Bedouin Arabs (n = 320) and Jews (n = 195), were randomly selected using an age-stratified sampling design. Human HEV IgG levels were determined using Wantai IgG ELISA assay. Of the samples obtained from camels, 68.6% were anti-HEV positive. Among the human populations, Bedouins and non-Bedouin Arabs had a significantly higher prevalence of HEV antibodies (21.6% and 15.0%, respectively) compared with the Jewish population (3.1%). Seropositivity increased significantly with age in all human populations, reaching 47.6% and 34.8% among ⩾40 years old, in Bedouins and non-Bedouin Arabs, respectively. The high seropositivity in camels and in ⩾40 years old Bedouins and non-Bedouin Arabs suggests that HEV is endemic in Israel. The low HEV seroprevalence in Jews could be attributed to higher socio-economic status.

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Section: Epidemiology and Infectionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Seroprevalence of hepatitis E virus in dromedary camels, Bedouins, Muslim Arabs and Jews in Israel, 2009–2017

et al. 2019

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“…Donor seroprevalence is cited as 26% in one South African study (n = 300). 45 Hepatitis E virus is transfusion transmissible and can lead to fulminant hepatitis in high-risk groups (e.g., pregnant women and those with preexisting liver dysfunction). 46,47 Human T-cell lymphotropic viruses 1 and 2…”

Section: Hepatitis Virusesmentioning

confidence: 99%

Blood transfusion safety in sub‐Saharan Africa: A literature review of changes and challenges in the 21st century

Weimer

Tagny

Tapko³

et al. 2018

Transfusion

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BACKGROUND Access to a safe, adequate blood supply has proven challenging in sub‐Saharan Africa, where systemic deficiencies spanning policy, collections, testing, and posttransfusion surveillance have long been recognized. Progress in transfusion safety in the early 2000s was in large part due to intervention by the World Health Organization and other foreign governmental bodies, coupled with an influx of external funding. STUDY DESIGN AND METHODS A review of the literature was conducted to identify articles pertaining to blood safety in sub‐Saharan Africa from January 2009 to March 2018. The search was directed toward addressing the major elements of the blood safety chain, in the countries comprising the World Health Organization African region. Of 1380 articles, 531 met inclusion criteria and 136 articles were reviewed. RESULTS External support has been associated with increased recruitment of voluntary donors and expanded testing for the major transfusion‐transmitted infections (TTIs). However, the rates of TTIs among donors remain high. Regional education and training initiatives have been implemented, and a tiered accreditation process has been adopted. However, a general decline in funding for transfusion safety (2009 onwards) has strained the ability to maintain or improve transfusion‐related services. Critical areas of need include data collection and dissemination, epidemiological surveillance for TTIs, donor recruitment, quality assurance and oversight (notably laboratory testing), and hemovigilance. CONCLUSION Diminishing external support has been challenging for regional transfusion services. Critical areas of deficiency in regional blood transfusion safety remain. Nonetheless, substantive gains in education, training, and accreditation suggest durable gains in regional capacity.

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“…[3] The latter study suggested waterborne transmission (odds ratio (OR) 2.85). [3] Recent studies in Cape Town (the Western Cape) reported HEV seroprevalence rates of 28% and 26% in patients without liver disease attending clinics at teaching hospitals [1] and in blood donors, [4] respectively. Both studies showed an increase in seroprevalence with age.…”

Section: Researchmentioning

confidence: 99%

Hepatitis E virus in patients with acute hepatitis in Cape Town, South Africa, 2011

2019

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Background. Early hepatitis E virus (HEV) seroprevalence studies in South Africa (SA) showed seroprevalence rates of 2 -10%, and suggested waterborne transmission. More recent studies in Cape Town, SA, reported HEV seroprevalence rates of 28% and 26% in outpatients without liver disease and blood donors, respectively. An association was found with eating pork or bacon/ham. Only 3 human cases of hepatitis E in SA have been reported in the literature. Objectives. To find evidence of HEV infection in hospitalised patients with acute hepatitis and no other identified cause. Methods. Leftover serum samples were retrieved for patients negative for hepatitis viruses A, B and C, where no other cause of hepatitis was identified. Samples were tested for HEV by polymerase chain reaction (PCR) and IgM and IgG enzyme-linked immunosorbent assay (ELISA). Results. Anti-HEV IgG was detected in 39/132 specimens (29.5%; 95% confidence interval (CI) 22.4 -37.8), and anti-HEV IgM in 2/125 specimens (1.6%; 95% CI 0.4 -5.7). No specimen tested positive by PCR. Conclusions. IgG seroprevalence found in this study was similar to that previously reported in Cape Town. IgM positivity in 2 patients was not confirmed by PCR. Locally, hepatitis E may not be a common cause of clinically apparent hepatitis that requires hospitalisation.

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Racial differences in seroprevalence of HAV and HEV in blood donors in the Western Cape, South Africa: a clue to the predominant HEV genotype?

Cited by 13 publications

References 12 publications

Seroprevalence of hepatitis E virus in dromedary camels, Bedouins, Muslim Arabs and Jews in Israel, 2009–2017

Seroprevalence of hepatitis E virus in dromedary camels, Bedouins, Muslim Arabs and Jews in Israel, 2009–2017

Blood transfusion safety in sub‐Saharan Africa: A literature review of changes and challenges in the 21st century

Hepatitis E virus in patients with acute hepatitis in Cape Town, South Africa, 2011

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