Seroepidemiology of hepatitis E virus in the Egyptian Nile Delta

Abstract

The seroendemicity of hepatitis E virus (HEV) in an entire village population located in the Egyptain Nile Delta is described. Serum specimens were obtained from 68% of the total population of 1,850 villagers. The lack of serum specimen was greatest in the youngest age group (< 5). Commercially available enzyme immunoassays (EIA) for antibody to hepatitis A virus (anti-HAV), to hepatitis B virus core antigen (anti-HBc), to second-generation hepatitis C virus (anti-HCV) core and nonstructural antigen, and to hepatitis E virus (HEV) were used. Only repeated reactive sera were coded as positive. Stool specimens were examined for Schistosoma mansoni by the Kato method and standard methods for the examination of the liver and spleen by ultrasonography were used. Unadjusted for nonrespone, the seroprevalence of anti-HEV was 17.2% (SE +/- 1.1). Anti-HEV seroprevalence increased by age and was not associated statistically with any of the other viral markers including HCV. Anti-HAV seroprevalence was consistently > 95%, even in the youngest age group (< 5). The overall sero-endemicity of HEV was higher than reported elsewhere and appears not to have been introduced into the village population recently.

Seroepidemiology of hepatitis E virus infection in 2-25-year-olds in Sari district, Islamic Republic of Iran

“…The results showed that HEV infection is endemic, acquired early in life and its seroprevalence rate increased steadily with age, reaching 7.3% in young adults. The patterns of increase are similar to those reported in many other studies from different endemic countries [10,[15][16][17][18][19][20][21]. In north India, a region with high endemicity for HEV infection, exposure to HEV was shown to occur in early life and seropositivity for anti-HEV IgG increased progressively from 7.2%-14.2% in infancy to 33.3%-38.0% by 10 years of age in rural and urban children respectively [10].…”

“…In north India, a region with high endemicity for HEV infection, exposure to HEV was shown to occur in early life and seropositivity for anti-HEV IgG increased progressively from 7.2%-14.2% in infancy to 33.3%-38.0% by 10 years of age in rural and urban children respectively [10]. A similar epidemiological picture was also seen in other studies from Turkey [17,18], Saudi Arabia [19], Egypt [20] and Mexico [21]. A study by Kamel et al on the seroepidemiology of HEV infection in an entire village population located in the Egyptian Nile delta showed seropositivity of 5.19% in the age group < 5 years, increasing progressively and peaking at 33.33% in the age group 20-24 years [20].…”

“…They were selected by randomized age-stratified sampling from urban and rural areas of Sari district, the capital of Mazandaran province, northern Islamic Republic of Iran (population 450 000 and 110 000-120 000 in the range 2-25 years). The sample size (1152) was calculated based on studies from other countries [10,[15][16][17][18][19][20][21] and probable prevalence of 25%. Individuals with acute infection, pregnancy, immunodeficiency, receiving blood or blood products within the last 3 months and chronic renal and liver diseases were excluded.…”

Prevalence of antibodies to hepatitis E in two rural Egyptian communities.

“…6 In Egypt, where outbreaks of hepatitis E have not been noted, reports have indicated that HEV infection is, nonetheless, endemic, with community seroprevalence as high as 60%. 7,8 However, until now, there have not been any large studies to confirm these unusually high estimates. Here, we report a population-based study of anti-HEV prevalence in two communities in different regions of Egypt.…”

Emerging viral pathogens in long‐term expatriates (I): Hepatitis E virus

“…z % found in our population of long-term expatriates is situated between figures from serosurveys of populations in endemic areas such as Egypt with 17.2% (Kame1 et al 1995) and nonendemic areas such as Australia with 0.4% (Moaven et al 1995).…”