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Letafati A, Taghiabadi Z, Roushanzamir M, Memarpour B, Seyedi S, Farahani AV, Norouzi M, Karamian S, Zebardast A, Mehrabinia M, Ardekani OS, Fallah T, Khazry F, Daneshvar SF, Norouzi M. From discovery to treatment: tracing the path of hepatitis E virus. Virol J 2024; 21:194. [PMID: 39180020 PMCID: PMC11342613 DOI: 10.1186/s12985-024-02470-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 08/14/2024] [Indexed: 08/26/2024] Open
Abstract
The hepatitis E virus (HEV) is a major cause of acute viral hepatitis worldwide. HEV is classified into eight genotypes, labeled HEV-1 through HEV-8. Genotypes 1 and 2 exclusively infect humans, while genotypes 3, 4, and 7 can infect both humans and animals. In contrast, genotypes 5, 6, and 8 are restricted to infecting animals. While most individuals with a strong immune system experience a self-limiting infection, those who are immunosuppressed may develop chronic hepatitis. Pregnant women are particularly vulnerable to severe illness and mortality due to HEV infection. In addition to liver-related complications, HEV can also cause extrahepatic manifestations, including neurological disorders. The immune response is vital in determining the outcome of HEV infection. Deficiencies in T cells, NK cells, and antibody responses are linked to poor prognosis. Interestingly, HEV itself contains microRNAs that regulate its replication and modify the host's antiviral response. Diagnosis of HEV infection involves the detection of HEV RNA and anti-HEV IgM/IgG antibodies. Supportive care is the mainstay of treatment for acute infection, while chronic HEV infection may be cleared with the use of ribavirin and pegylated interferon. Prevention remains the best approach against HEV, focusing on sanitation infrastructure improvements and vaccination, with one vaccine already licensed in China. This comprehensive review provides insights into the spread, genotypes, prevalence, and clinical effects of HEV. Furthermore, it emphasizes the need for further research and attention to HEV, particularly in cases of acute hepatitis, especially among solid-organ transplant recipients.
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Affiliation(s)
- Arash Letafati
- Department of Virology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran.
| | - Zahra Taghiabadi
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Mahshid Roushanzamir
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
- Department of Pharmacological and Biomolecular Science, University of Milan, Milan, Italy
| | - Bahar Memarpour
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
- Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Saba Seyedi
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | | | - Masoomeh Norouzi
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Saeideh Karamian
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Arghavan Zebardast
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Marzieh Mehrabinia
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Omid Salahi Ardekani
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Tina Fallah
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Fatemeh Khazry
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Samin Fathi Daneshvar
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Mehdi Norouzi
- Department of Virology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
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Copado-Villagrana ED, Duarte-López IX, Calderón-Flores A, Loera-Robles I, Viera-Segura O, Fierro NA. Hepatitis E Virus Genotype 3 among Hemodialysis Patients in Mexico: First Identification of Chronic Infection. Pathogens 2024; 13:578. [PMID: 39057805 PMCID: PMC11280106 DOI: 10.3390/pathogens13070578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 06/30/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024] Open
Abstract
The global distribution of hepatitis E virus (HEV) is attributed to its capacity to spread through several routes of transmission; hemodialysis has gained increased amounts of attention in recent years. Although Mexico is considered a hyperendemic region for hepatitis E, no HEV surveillance is performed in the country. The frequency of HEV in hemodialysis (HD) patients has not been determined. Herein, we conducted a cross-sectional single-center analytical study including 67 serum samples from HD patients. Anti-HEV IgG and IgM antibodies and the viral genome were determined; partial regions within the HEV genome were sequenced for further phylogenetic analysis. Globally, 14.9% of the tested patients exhibited reactivity for IgG antibodies against HEV, and none showed reactivity to IgM. A total of 5.9% of the samples showed HEV genome amplification, and sequencing confirmed the identity of genotype 3; subsequent analysis of positive cases revealed two acute cases and chronic hepatitis E infection in one patient. Notably, the chronic patient was negative for anti-HEV IgG antibodies. Our findings highlight the importance of viral genome testing in HD patients and the need to establish guidelines for HEV detection in Mexico.
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Affiliation(s)
| | - Ilsy X. Duarte-López
- Unidad de Medicina Familiar 5, Instituto Mexicano del Seguro Social, Nogales 84000, Mexico; (E.D.C.-V.)
| | - Arturo Calderón-Flores
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Isidro Loera-Robles
- Unidad de Medicina Familiar 5, Instituto Mexicano del Seguro Social, Nogales 84000, Mexico; (E.D.C.-V.)
| | - Oliver Viera-Segura
- Instituto en Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico;
| | - Nora A. Fierro
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
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Memon MS, Kadir B, Kamani L, Chandio AA. Seroprevalence of Hepatitis-E Virus-Immunoglobulin G and its association with Chronic Liver Disease. Pak J Med Sci 2024; 40:1011-1016. [PMID: 38827844 PMCID: PMC11140340 DOI: 10.12669/pjms.40.5.8448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/22/2024] [Accepted: 02/18/2024] [Indexed: 06/05/2024] Open
Abstract
Background & Objective Viral hepatitis is a major public health concern in low-middle income countries. Hepatitis-E infection (HEV) is found globally but most prevalent in low-income countries especially those with poor sanitation systems, access to clean drinking water and health services. Superinfection with HEV in patients with chronic liver disease (CLD) can cause severe hepatic decompensation leading to increased morbidity and mortality. To determine the frequency of seroprevalence of Hepatitis-E virus Immunoglobulin g (IgG) and its association with chronic liver disease. Methods A cross-sectional study was conducted in Asian Institute of Medical Sciences, Hyderabad, Pakistan from January till May 2022. A total of 196 patients of aged ≥ 18 years, presenting in gastroenterology clinics were included in the study after informed consent. Result Among 196 patients, one third of patient were male (73.5%). Out of which 162 (82.7%) had liver disease and 34 (17.3%) were without liver disease. The median age of patient was 45 (33-51) years. The overall seroprevalence of HEV IgG among study population was 69.4%. HEV IgG was present in 114 and 22 in CLD and non CLD patients respectively. Multivariable regression shows no association between seroprevalence of HEV in CLD and non-CLD patient (AOR 1.02, 95% CI 0.45-2.313). Conclusion Our study showed high frequency of HEV seropositivity. No difference was observed in HEV seropositivity among CLD and non-CLD patients.
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Affiliation(s)
- Muhammad Sadik Memon
- Muhammad Sadik Memon, Professor, Asian Institute of Medical Sciences (AIMS) Hospital, Hyderabad, Pakistan
| | - Bushra Kadir
- Bushra Kadir, Consultant Gastroenterologist, Asian Institute of Medical Sciences (AIMS) Hospital, Hyderabad, Pakistan
| | - Lubna Kamani
- Lubna Kamani, Professor & Director GI Residency Program, Liaquat National Hospital, Karachi, Pakistan
| | - Ayaz Ahmed Chandio
- Ayaz Ahmed Chandio, Biostatician, Asian Institute of Medical Sciences (AIMS) Hospital, Hyderabad, Pakistan
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Martino C, Di Luca A, Bennato F, Ianni A, Passamonti F, Rampacci E, Henry M, Meleady P, Martino G. Label-Free Quantitative Analysis of Pig Liver Proteome after Hepatitis E Virus Infection. Viruses 2024; 16:408. [PMID: 38543773 PMCID: PMC10976091 DOI: 10.3390/v16030408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 05/23/2024] Open
Abstract
Hepatitis E represents an emerging zoonotic disease caused by the Hepatitis E virus (HEV), for which the main route of transmission is foodborne. In particular, infection in humans has been associated with the consumption of contaminated undercooked meat of pig origin. The aim of this study was to apply comparative proteomics to determine if porcine liver protein profiles could be used to distinguish between pigs seropositive and seronegative for HEV. Preliminarily, an ELISA was used to evaluate the presence of anti-HEV antibodies in the blood serum of 136 animals sent to slaughter. Among the analyzed samples, a seroprevalence of 72.8% was estimated, and it was also possible to identify 10 animals, 5 positive and 5 negative, coming from the same farm. This condition created the basis for the quantitative proteomics comparison between homogeneous animals, in which only the contact with HEV should represent the discriminating factor. The analysis of the proteome in all samples of liver exudate led to the identification of 554 proteins differentially expressed between the two experimental groups, with 293 proteins having greater abundance in positive samples and 261 more represented in negative exudates. The pathway enrichment analysis allowed us to highlight the effect of the interaction between HEV and the host biological system in inducing the potential enrichment of 69 pathways. Among these, carbon metabolism stands out with the involvement of 41 proteins, which were subjected to interactomic analysis. This approach allowed us to focus our attention on three enzymes involved in glycolysis: glucose-6-phosphate isomerase (GPI), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), and fructose-bisphosphate aldolase A (ALDOA). It therefore appears that infection with HEV induced a strengthening of the process, which involves the breakdown of glucose to obtain energy and carbon residues useful for the virus's survival. In conclusion, the label-free LC-MS/MS approach showed effectiveness in highlighting the main differences induced on the porcine liver proteome by the interaction with HEV, providing crucial information in identifying a viral signature on the host metabolism.
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Affiliation(s)
- Camillo Martino
- Department of Veterinary Medicine, University of Perugia, 06126 Perugia, Italy; (C.M.); (F.P.); (E.R.)
| | - Alessio Di Luca
- Department of BioScience and Technology for Food, Agriculture, and Environment, University of Teramo, 64100 Teramo, Italy; (A.D.L.); (F.B.); (G.M.)
| | - Francesca Bennato
- Department of BioScience and Technology for Food, Agriculture, and Environment, University of Teramo, 64100 Teramo, Italy; (A.D.L.); (F.B.); (G.M.)
| | - Andrea Ianni
- Department of BioScience and Technology for Food, Agriculture, and Environment, University of Teramo, 64100 Teramo, Italy; (A.D.L.); (F.B.); (G.M.)
| | - Fabrizio Passamonti
- Department of Veterinary Medicine, University of Perugia, 06126 Perugia, Italy; (C.M.); (F.P.); (E.R.)
| | - Elisa Rampacci
- Department of Veterinary Medicine, University of Perugia, 06126 Perugia, Italy; (C.M.); (F.P.); (E.R.)
| | - Michael Henry
- National Institute for Cellular Biotechnology, Dublin City University, D09 DX63 Dublin, Ireland; (M.H.); (P.M.)
| | - Paula Meleady
- National Institute for Cellular Biotechnology, Dublin City University, D09 DX63 Dublin, Ireland; (M.H.); (P.M.)
| | - Giuseppe Martino
- Department of BioScience and Technology for Food, Agriculture, and Environment, University of Teramo, 64100 Teramo, Italy; (A.D.L.); (F.B.); (G.M.)
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Orozco-Cordoba J, Mazas C, Du Pont G, Lamoyi E, Cárdenas G, Fierro NA. Viral Biology and Immune Privilege in the Development of Extrahepatic Manifestations During Hepatitis E Virus Infection. Viral Immunol 2023; 36:627-641. [PMID: 38064537 DOI: 10.1089/vim.2023.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
Hepatitis E virus (HEV) exhibits tropism toward hepatocytes and thus affects the liver; however, HEV may also affect other tissues, including the heart, kidneys, intestines, testicles, and central nervous system. To date, the pathophysiological links between HEV infection and extrahepatic manifestations have not yet been established. Considering that HEV infects multiple types of cells, the direct effects of virus replication in peripheral tissues represent a plausible explanation for extrahepatic manifestations. In addition, since the immune response is crucial in the development of the disease, the immune characteristics of affected tissues should be revisited to identify commonalities explaining the effects of the virus. This review summarizes the most recent advances in understanding the virus biology and immune-privileged status of specific tissues as major elements for HEV replication in diverse organs. These discoveries may open avenues to explain the multiple extrahepatic manifestations associated with HEV infection and ultimately to design effective strategies for infection control.
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Affiliation(s)
- Javier Orozco-Cordoba
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
| | - Camila Mazas
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
| | - Gisela Du Pont
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
| | - Edmundo Lamoyi
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
| | - Graciela Cárdenas
- Departamento de Neuroinfectología, Instituto Nacional de Neurología Manuel Velasco Suárez, Mexico City, Mexico
| | - Nora A Fierro
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
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Bhatti TK, Singal AK, Kwo PY. Viral Hepatitis and Acute-on-Chronic Liver Failure. Clin Liver Dis 2023; 27:617-630. [PMID: 37380286 DOI: 10.1016/j.cld.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Acute-on-chronic liver failure (ACLF) is a potentially reversible syndrome that develops in patients with cirrhosis or with underlying chronic liver disease (CLD) and is characterized by acute decompensation, organ failure, and high short-term mortality. Hepatitis A and hepatitis E are major causes of ACLF. Hepatitis B may also cause ACLF through a flare of hepatitis B, acute infection, or reactivation. Besides supportive care, nucleoside/nucleotide analog therapy should also be initiated in this setting. Nonhepatotropic viruses may rarely also cause ACLF with the severe acute respiratory syndrome coronavirus 2 virus recently being identified with poorer outcomes in those with underlying CLD.
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Affiliation(s)
| | - Ashwani K Singal
- University of SD Sanford School of Medicine, Sioux Falls, SD, USA
| | - Paul Y Kwo
- Stanford University School of Medicine, Palo Alto, CA, USA.
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Songtanin B, Molehin AJ, Brittan K, Manatsathit W, Nugent K. Hepatitis E Virus Infections: Epidemiology, Genetic Diversity, and Clinical Considerations. Viruses 2023; 15:1389. [PMID: 37376687 DOI: 10.3390/v15061389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
According to the World Health Organization, approximately 20 million people worldwide are infected annually with the hepatitis E virus (HEV). There are four main genotypes of HEV. Genotype 1 and genotype 2 are common in developing countries and are transmitted by contaminated water from a fecal-oral route. Genotype 3 and genotype 4 are common in developed countries and can lead to occasional transmission to humans via undercooked meat. Hepatitis E virus 1 and HEV3 can lead to fulminant hepatitis, and HEV3 can lead to chronic hepatitis and cirrhosis in immunocompromised patients. The majority of patients with HEV infection are asymptomatic and usually have spontaneous viral clearance without treatment. However, infection in immunocompromised individuals can lead to chronic HEV infection. Both acute and chronic HEV infections can have extrahepatic manifestations. No specific treatment is required for acute HEV infection, no treatment has been approved in chronic infection, and no HEV vaccine has been approved by the (United States) Food and Drug Administration. This review focuses on the molecular virology (HEV life cycle, genotypes, model systems, zoonosis), pathogenesis, clinical manifestation, and treatment of chronic HEV infection, especially in immunocompromised patients, to provide clinicians a better understanding of the global distribution of these infections and the significant effect they can have on immunocompromised patients.
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Affiliation(s)
- Busara Songtanin
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Adebayo J Molehin
- Department of Microbiology & Immunology, College of Graduate Studies, Midwestern University, Glendale, AZ 85308, USA
| | - Kevin Brittan
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Wuttiporn Manatsathit
- Department of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
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Cao X, Jiang W, Shi L, Wang Y, Chen J, Huang W, Zhang S. Acalculous cholecystitis is a common extrahepatic manifestation of hepatitis E and suggests a more serious condition. Virol J 2023; 20:77. [PMID: 37095526 PMCID: PMC10124029 DOI: 10.1186/s12985-023-02045-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/18/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND This study aimed to understand the incidence and clinical significance of acalculous cholecystitis in patients with acute hepatitis E (HE). PATIENTS AND METHODS A single center enrolled 114 patients with acute HE. All patients underwent imaging of the gallbladder, and patients with gallstones and cholecystectomy were excluded. RESULTS Acalculous cholecystitis was found in 66 patients (57.89%) with acute HE. The incidence in males was 63.95%, which was significantly higher than in females (39.29%) (P = 0.022). The mean length of hospital stay and the incidence of spontaneous peritonitis in patients with cholecystitis (20.12 ± 9.43 days and 9.09%, respectively) were significantly higher than those in patients without cholecystitis (12.98 ± 7.26 days and 0%, respectively) (P < 0.001 and P = 0.032). Albumin, total bile acid, bilirubin, cholinesterase, and prothrombin activity in patients with cholecystitis were significantly inferior to those in patients without cholecystitis (P < 0.001, P < 0.001, P < 0.001, P < 0.001 and P = 0.003, respectively). After correction by multivariate analysis, albumin and total bile acid were found to be closely related to acalculous cholecystitis in HE. CONCLUSION Acalculous cholecystitis is very common in patients with acute HE, and may serve as a predictor of increased peritonitis, synthetic decompensation, and longer hospital stay.
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Affiliation(s)
- Xuemei Cao
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Wei Jiang
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Lingfeng Shi
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
- Department of Infectious Diseases, Youyang Hospital, A Branch of The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yanping Wang
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Chen
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Wenxiang Huang
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Shujun Zhang
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
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Hepatitis E Virus (HEV) in Makkah, Saudi Arabia: A Population-Based Seroprevalence Study. Viruses 2023; 15:v15020484. [PMID: 36851698 PMCID: PMC9964995 DOI: 10.3390/v15020484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND The Hepatitis E virus (HEV) is a common cause of viral hepatitis worldwide. Little is known about the seroprevalence of HEV in the general population of Saudi Arabia. METHODS A community-based cross-sectional HEV seroprevalence study was conducted in Makkah, Saudi Arabia. Anti-HEV IgG antibodies were detected in sera using an in-house ELISA. The frequency of HEV sageerology and its correlation with demographic, and environmental factors were evaluated. RESULTS Enrollment consisted of 1329 individuals, ages ranged from 8 to 88 years, the mean age was 30.17 years, the median age was 28yrs, and the male: female ratio was 1.15. The overall seroprevalence was 23.8% (316/1329). Males had significantly higher seroprevalence than females (66.1 vs. 33.9%; p < 0.001). Seroprevalence had significant correlations with age, occupation, and lack of regular water supply and housing conditions. CONCLUSIONS This is the first HEV community-based seroprevalence study from Saudi Arabia. Results show that the HEV is endemic in Makkah and affects all age groups and occupations. HEV affects more males than females and those living in crowded accommodations without a regular supply of water. Further studies are required across all regions of Saudi Arabia to determine the country's seroprevalence of active or past infection using tests for HEV IgG, HEV IgM antibodies and/or HEV RNA and underlying determinants of transmission.
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Ehi Airiohuodion P, Wartel A, Yako AB, Mac PA. Seroprevalence and burden of hepatitis E viral infection among pregnant women in central Nigeria attending antenatal clinic at a Federal Medical Centre in Central Nigeria. Front Med (Lausanne) 2022; 9:888218. [PMID: 36117965 PMCID: PMC9478474 DOI: 10.3389/fmed.2022.888218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionHEV infection may be life threatening in pregnant women and has been linked with 20–30% mortality, especially in the third trimester of pregnancy. HEV infection leads to elevated levels of preterm labour and other immunological parameters. It is vertically transmitted and could lead to poor feto-maternal outcomes. especially in fulminating viral hepatitis where both the mother and foetus could be lost. There is currently no known treatment or vaccine for HEV. There is therefore a need to study HEV seroprevalence and burden among vulnerable groups, such as pregnant women and their newborns in Nigeria, where maternal mortality is highly significant.MethodsA total of 200 samples were collected from pregnant women attending antenatal clinic at Federal Medical Centre (FMC) Keffi, in central Nigeria, of which (156/200) samples were from HIV-negative pregnant women and (44/200) were from HIV-positive pregnant women, using a simple random sampling method.ResultsIn total, 200 pregnant women [78.0% (156/200) HIV-negative pregnant women and 22.0% (44/200) HIV-positive pregnant women] were recruited for this study. The ages of the pregnant women ranged from 15-49 years, with a mean age of 26.4 years (± 6.23). The overall HEV IgG seropositivity in the study population was 31.5% (63/200); 95% CI (30-33).ConclusionThis study highlighted an unexpectedly high seroprevalence of HEV and poor feto-maternal outcomes in pregnant women residing in a rural and urban setting of central Nigeria. The study showed that the inherently high HEV seropositivity and poor feto-maternal outcomes may not be attributed to HEV viral hepatitis only but may be a combination of extrinsic and intrinsic factors.
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Affiliation(s)
- Philomena Ehi Airiohuodion
- Faculty of Medicine, Centre for Medicine, and Society, University of Freiburg, Freiburg, Germany
- Special Programme for Research & Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Anh Wartel
- International Vaccine Research Institute, Seoul, South Korea
| | - Andrew B. Yako
- Department of Zoology, Nasarawa State University, Keffi, Nigeria
| | - Peter Asaga Mac
- Faculty of Medicine, Centre for Medicine, and Society, University of Freiburg, Freiburg, Germany
- Institute of Virology, Universitätsklinikum Freiburg, Freiburg, Germany
- *Correspondence: Peter Asaga Mac, ;
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