Hepatitis E Virus Seroprevalence and Associated Risk Factors in Apparently Healthy Individuals from Osun State, Nigeria

Hepatitis E virus seroprevalence among employees in catering and public place industries in Nanjing, China

This study aimed to assess the prevalence of anti-hepatitis E virus (HEV) immunoglobulin (Ig) M and elevated serum alanine aminotransferase (ALT) levels among employees in catering and public place industries. Blood samples were collected between January and December 2020 from 26,790 employees working in the Qinhuai district of Nanjing, China. Anti-HEV IgM in the serum samples was tested by the capture ELISA method and ALT was tested by the IFCC method. Samples positive for anti-HEV IgM or with ALT levels over 200 U/L were subjected to PCR screening of HEV RNA. The overall seroprevalence of anti-HEV IgM was 0.41%, and the seroprevalence was slightly higher in males (0.47%) than in females (0.37%); however, the difference was not substantial (p = 0.177). Seroprevalence of anti-HEV IgM increased with age, reaching its peak level after 48 years of age. The prevalence of elevated ALT levels was 4.24%, and males exhibited a higher prevalence than females (6.78% vs 2.65%, p < 0.001). Prevalence of elevated ALT levels differed in age groups and the 26-36-year-old group had the highest rate of elevated ALT levels. Employees with elevated ALT levels had a higher prevalence of positive anti-HEV IgM than those with normal ALT (0.57% vs 0.31%, p < 0.001). Positive HEV RNA was detected in one anti-HEV IgM-negative employee with ALT higher than 200 U/L. In our study, all the HEV RNA-positive and IgM-positive individuals are asymptomatic, and a combination of ALT tests, serological methods, and molecular methods is recommended to screen asymptomatic HEV carriers and reduce the risk of transmission.

Relative risk factors for seropositive hepatitis E virus among blood donors and haemodialysis patients: The pivotal role of primary health care education

Background:

Hepatitis E virus is a zoonotic virus with a worldwide epidemic outbreak. The aim of the study was to identify relative risk factors and co-infections concerning the seropositive HEV IgG among blood donors and haemodialysis (HD) patients in the central blood bank and renal dialysis centre in Wad Medani city, Gezira State, Sudan.

Materials and Methods:

This was a cross-sectional study that included 600 participants, among them 180 showed strong seropositive HEV IgG. The structured questionnaire was used to collect data of the participants’ demographics, disease risk factors and HEV IgG co-infections with HBV, HCV, HIV and syphilis.

Results:

Among the 180 strong seropositive HEV IgG respondents, 84 were blood donors and 96 were haemodialysis patients. The gender and age (18–30 years) had a significant association with the virus exposure (P = 0.000, P = 0.000). Importantly, a significant association of HEV prevalence due to the localities effect exhibited with the highest rate among South Gezira (OR = 38, CI = 14.1–107; P = 0.000). This also observed in Wad Medani, Umm Algura, East Gezira and Managil localities (P = 0.000). The effect of the animal contact on HEV distribution exerted the significant association among the respondents for blood donors and haemodialysis patients in univariate (OR = 4.09, 95% CI 1.5–10.9; P = 0.005) and multivariate (OR = 3.2, CI = 1.1–9.4; P = 0.027) analysis.

Conclusion:

The relative risk factors of the HEV seroprevalence were gender, age, locality and animal contact. Besides the need of a regular survey for the virus seroprevalence, primary health care physicians can play pivotal role in health education, especially in rural areas of Sudan. In addition, primary health care physicians in Sudan are expected to establish strategies and plans to eradicate and minimise the health impact of HEV.

Hepatitis E virus infection in high-risk populations in Osun State, Nigeria

Hepatitis E virus (HEV) infection is an emerging infection that is of major public health concern, especially in some vulnerable groups like immunosuppressed individuals, pregnant women and HBV-coinfected individuals. HEV is transmitted faecal/oral or zoonotically depending on the HEV-genotype. This study aimed at investigating HEV infections among different at-risk populations in Osun State, Southwestern Nigeria. A total of 720 serum samples were collected from animal handlers, pregnant women, people living with HIV/AIDS, and Hepatitis B virus (HBV) infected individuals. Commercially available Enzyme-Linked Immunosorbent Assays (ELISA) were used for the detection of anti-HEV total and IgM antibodies. Polymerase chain reaction (PCR) was carried out in the HEV seropositive samples and all the samples from individuals infected with HBV. Descriptive analysis and chi-square test of association were performed.

The anti-HEV total antibody seroprevalence in HIV-positive individuals, animal handlers and pregnant women was 11.4% (n = 47/411), 7.9% (n = 7/89), and 6.3% (n = 10/160), respectively. Markers of acute HEV infection (anti-HEV IgM) were detected in 2.2% of HIV-positive individuals (n = 9/411) and 1.8% of animal handlers (n = 2/89), respectively, and in 0.6% of pregnant women (n = 1/160). However, all samples were HEV RNA negative.

This study analysed the presence of markers of HEV infection among different at-risk populations without clinical symptoms of HEV infection. Our results showed that HEV is an underestimated threat to public health in Nigeria and underlines the need of an HEV surveillance system to understand the distribution and transmission of HEV infection in animals and/to humans.

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The risk of HEV-infection in at-risk populations like animal handlers, pregnant, or HIV infected individuals were assessed.

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Anti-HEV seroprevalence in animal handlers, HIV-positive individuals, and pregnant was 11.4%, 7.9%, and 6.3%, respectively.

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Anti-HEV IgM antibodies were detected in 2.2% of HIV-positive individuals, 1.8% of animal handlers, and in 0.6% of pregnant.

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The finding has One Health implication underscoring the need of HEV surveillance to understand animal-to-human transmission.

Assessment of socioeconomic inequality based on virus-contaminated water usage in developing countries: A review

Water is an essential resource required for various human activities such as drinking, cooking, and other recreational activities. While developed nations have made significant improvement in providing adequate quality water and sanitation devoid of virus contaminations to a significant percentage of the residences, many of the developing countries are still lacking in these regards, leading to many death cases among the vulnerable due to ingestion of virus-contaminated water and other waterborne pathogens. However, the recent global pandemic of COVID-19 seems to have changed the paradigm by reawakening the importance of water quality and sanitation, and focusing more attention on the pervasive effect of the use of virus-contaminated water as it can be a potential driver for the spread of the virus and other waterborne diseases, especially in developing nations that are characterized by low socioeconomic development. Therefore, this review assessed the socioeconomic inequalities related to the usage of virus-contaminated water and other waterborne pathogens in developing countries. The socioeconomic factors attributed to the various waterborne diseases due to the use of virus-contaminated water in many developing countries are poverty, the standard of living, access to health care facilities, age, gender, and level of education. Some mitigation strategies to address the viral contamination of water sources are therefore proposed, while future scope and recommendations on tackling the essential issues related to socioeconomic inequality in developing nations are highlighted.

Assessment of socioeconomic inequality based on virus-contaminated water usage in developing countries: A review

Water is an essential resource required for various human activities such as drinking, cooking, and other recreational activities. While developed nations have made significant improvement in providing adequate quality water and sanitation devoid of virus contaminations to a significant percentage of the residences, many of the developing countries are still lacking in these regards, leading to many death cases among the vulnerable due to ingestion of virus-contaminated water and other waterborne pathogens. However, the recent global pandemic of COVID-19 seems to have changed the paradigm by reawakening the importance of water quality and sanitation, and focusing more attention on the pervasive effect of the use of virus-contaminated water as it can be a potential driver for the spread of the virus and other waterborne diseases, especially in developing nations that are characterized by low socioeconomic development. Therefore, this review assessed the socioeconomic inequalities related to the usage of virus-contaminated water and other waterborne pathogens in developing countries. The socioeconomic factors attributed to the various waterborne diseases due to the use of virus-contaminated water in many developing countries are poverty, the standard of living, access to health care facilities, age, gender, and level of education. Some mitigation strategies to address the viral contamination of water sources are therefore proposed, while future scope and recommendations on tackling the essential issues related to socioeconomic inequality in developing nations are highlighted.