Sporadic cases of acute autochthonous hepatitis E in Spain

Buti, Marı́a; Clemente-Casares, Pilar; Jardí, R.; Formiga-Cruz, Meritxell; Schaper, Melanie; Valdés, Auristela; Rodríguez‐Frías, Francisco; Esteban, Rafael; Gironés, Rosina

doi:10.1016/j.jhep.2004.03.013

Cited by 91 publications

(76 citation statements)

References 32 publications

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“…In a study carried out by our group, anti-HEV antibodies were detected in only 5.6% of cases of non-A, non-B, and non-C acute hepatitis and in 4% of cases of acute hepatitis A (5,16,30). These data contrast with the 43% prevalence of HEV detected in sewage in different years, a prevalence considered high for a region where HEV infection is nonendemic (30).…”

Section: Discussionmentioning

confidence: 69%

Community-Based Seroepidemiological Survey of Hepatitis E Virus Infection in Catalonia, Spain

Buti

Domı́nguez

Plans

et al. 2006

Clin Vaccine Immunol

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The objective of the study was to investigate the prevalence of immunoglobulin G (IgG) antibodies to hepatitis E virus (HEV) infection in a population sample from Catalonia and to analyze the demographic and clinical variables associated with the presence of these antibodies. A total of 1,280 subjects between 15 and 74 years of age were selected randomly from urban and rural areas. Data for sociodemographic and clinical variables were collected by using a questionnaire. IgG antibodies to HEV were determined by an immunoenzymatic method. The odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated for studied variables. Multiple logistic regression analysis was used to determine which variables were independently associated with the prevalence of HEV infection. Anti-HEV antibodies were detected in 96 (7.3%) of the 1,280 samples analyzed. The prevalence of antibodies was greater among males (7.8%) than among women (7%) and increased with age for both sexes, from 3% among subjects 15 to 24 years of age to 12% among subjects >65 years of age. Bivariate analysis of the sociodemographic and clinical variables showed an association between the prevalence of hepatitis E virus infection and minor surgery (OR, 1.96; 95% CI, 1.24 to 3.11), abdominal surgery (OR, 1.74; 95% CI, 1.12 to 2.73), and, for women, being uniparous or multiparous (OR, 2.84; 95% CI, 1.19 to 6.79). The multivariate analysis showed an association with minor surgery only (OR, 1.68; 95% CI, 1.03 to 2.70). In conclusion, anti-HEV antibodies were detected in 7.3% of the Catalan population. The seroprevalence of anti-HEV antibodies increased with age and was associated with previous minor surgery.

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Section: Discussionmentioning

confidence: 69%

Community-Based Seroepidemiological Survey of Hepatitis E Virus Infection in Catalonia, Spain

Buti

Domı́nguez

Plans

et al. 2006

Clin Vaccine Immunol

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“…However, it has been seen on some occasions that the conversion of anti-HEV-positive IgG to undetectable levels during the acute phase is strongly associated with the detection of acute HEV infection, and may be the only marker detected (16).…”

Section: Discussionmentioning

confidence: 99%

Autochthonous acute hepatitis E: an increasingly frequent diagnosis. Clinical-epidemiological analysis of our experience

Ron¹,

Palacios²,

Torres³

et al. 2017

Rev Esp Enferm Dig

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Background: In Europe, acute hepatitis caused by the hepatitis E virus (HEV) traditionally was an infection found in people who had travelled to endemic zones, mainly Asia and Africa. However, a growing number of sporadic autochthonous cases are now being diagnosed in the Western world.Objective: To analyze the cases of acute HEV hepatitis diagnosed in our setting, with the identification of the clinicalepidemiological characteristics. Material and methods:We included the cases of acute HEV hepatitis diagnosed (positive anti-HEV IgM and/or HEV RNA present in serum) between January 2008 and December 2014. Different clinical, epidemiological and evolutive parameters were analyzed.Results: A total of 23 patients were identified, all originating from Spain. Fourteen cases (60.87%) presented jaundice and marked cytolysis at the time of diagnosis (aspartate aminotransferase [AST] 1,106.91 U/l and alanine aminotransferase [ALT] 1,407.04 U/l). Twenty-two cases were regarded as autochthonous, and one patient had travelled to China three months before. The mean time to resolution was 11.2 weeks. Some autoimmune markers were positive in 43.5% of the patients. Two subjects were diagnosed with previous chronic liver disease and were classified as "acuteon-chronic liver failure" (ACLF), one died and the other underwent liver transplantation.Conclusion: Acute HEV hepatitis in our setting is an autochthonous condition that is probably underdiagnosed, manifesting with jaundice and cytolysis. Autoimmune marker positivity is an epiphenomenon, which in some cases complicates the diagnosis.

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“…For instance, foodborne transmission of HEV was described in Japan, where consumption of undercooked game meat and pig livers led to clinical disease in humans [5][6][7]. However, no source has yet been documented for any reported locally acquired case in Europe and the United States [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Bayesian estimation of hepatitis E virus seroprevalence for populations with different exposure levels to swine in The Netherlands

et al. 2007

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SUMMARYHepatitis E virus (HEV) is ubiquitous in pigs worldwide and may be zoonotic. Previous HEV seroprevalence estimates for groups of people working with swine were higher than for control groups. However, discordance among results of anti-HEV assays means that true seroprevalence estimates, i.e. seroprevalence due to previous exposure to HEV, depends on choice of seroassay. We tested blood samples from three subpopulations (49 swine veterinarians, 153 non-swine veterinarians and 644 randomly selected individuals from the general population) with one IgM and two IgG ELISAs, and subsets with IgG and/or IgM Western blots. A Bayesian stochastical model was used to combine results of all assays. The model accounted for imperfection of each assay by estimating sensitivity and specificity, and accounted for dependence between serological assays. As expected, discordance among assay results occurred. Applying the model yielded seroprevalence estimates of y11 % for swine veterinarians, y6% for non-swine veterinarians and y2% for the general population. By combining the results of five serological assays in a Bayesian stochastical model we confirmed that exposure to swine or their environment was associated with elevated HEV seroprevalence.

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Sporadic cases of acute autochthonous hepatitis E in Spain

Cited by 91 publications

References 32 publications

Community-Based Seroepidemiological Survey of Hepatitis E Virus Infection in Catalonia, Spain

Community-Based Seroepidemiological Survey of Hepatitis E Virus Infection in Catalonia, Spain

Autochthonous acute hepatitis E: an increasingly frequent diagnosis. Clinical-epidemiological analysis of our experience

Bayesian estimation of hepatitis E virus seroprevalence for populations with different exposure levels to swine in The Netherlands

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