Time Trend of the Prevalence of Hepatitis E Antibodies among Farmers and Blood Donors: A Potential Zoonosis in Denmark

Abstract

Background Antibody to hepatitis E virus (anti-HEV) is prevalent in Western countries, where clinical hepatitis E is rarely reported. The aim of this study was to determine the prevalence of anti-HEV among Danish blood donors and Danish farmers. In addition, we compared the prevalence among 2 sets of serum samples obtained from blood donors 20 years apart. Methods Samples from 291 Danish farmers and 169 blood donors that were collected in 1983 and samples from 461 blood donors that were collected in 2003 were tested for anti-HEV. Relevant information on HEV exposure was collected by self-administered questionnaire. Results Anti-HEV testing was performed on samples after 20 years of storage at −20°C. The prevalence of anti-HEV was 50.4% among farmers and 32.9% among donors in 1983 and 20.6% among donors in 2003 (P < .05). Presence of anti-HEV was significantly correlated with increasing age in all 3 groups (P < .05). Among donors who had serum samples obtained in 2003, age, contact with horses, and the presence of antibody to hepatitis A virus were associated with the presence of anti-HEV in multivariate analysis. Among farmers, only age was independently associated with the presence of anti-HEV. Conclusion Anti-HEV was highly prevalent among Danes but has decreased in prevalence over the past 50 years. Our study supports the hypothesis that HEV infection in Denmark may be an asymptomatic zoonotic infection.

Investigating the Seroprevalence of Hepatitis E Among Blood Donors Referring to Blood Donation Centers in Birjand County in Iran

“…The sero-prevalence of the infection in developing countries with poor sanitation as well as in developed countries has been reported to be respectively higher and lower than Iran (17)(18)(19). Abe et al (2006) reported that the sero-prevalence of hepatitis E in Europe, Brazil, Japan, China, and the Middle East is respectively 0.95% -20.6%, 2.3%, 3.7%, 32.6%, and 4% -5.2% (20).…”

Transmission routes and risk factors for autochthonous hepatitis E virus infection in Europe: a systematic review

“…However, the virus can also infect a considerable proportion of the human population, but only a minority appear to develop symptoms [3][4][5][6][7][8]. The key to understanding HEV transmission in Europe may lie in determining how the virus that circulates among pigs is transmitted to humans in sufficiently high doses to cause infection or overt disease.…”

“…In addition, unexpectedly high anti-HEV immunoglobulin G (IgG) seroprevalence among the general population has been reported from some industrialized countries, although the rates varied considerably between reports, ranging from 2 . 3 to 33 % [3][4][5][6][7][8][9].…”

Hepatitis E in Norway: seroprevalence in humans and swine

“…Although the transmission route for HEV-3 is not fully understood, studies have suggested that wild boars and domestic swine are the main reservoirs for human infection [3], either through direct contact or through the consumption of raw or undercooked meat from animals with active infection [4][5][6]. Additionally, HEV has been isolated from untreated wastewater, swine manure, swine slurry storage facilities, river water and shellfish [3].…”