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Viral hepatitis B and C are widely recognized problems in hemodialysis (HD) patients. There have been increasing reports of the importance of the hepatitis E virus (HEV) in recent years, but the worldwide data on the seroprevalence of HEV among them are conflicting. The aim of the present study was to assess the seroprevalence of HEV in HD patients and to analyze the predictors of seropositivity. This study was conducted in 2020 in the central part of southern Bulgaria. A total of 225 patients were enrolled. An enzyme-linked immunosorbent assay for the determination of anti-HEV IgM/IgG was used. All patients were tested for the presence of HEV RNA. Anti-HEV IgM alone and anti-HEV IgG alone were found in 6 (2.7%) and 14 (6.2%) patients, respectively, and in 4 (1.8%) patients, they were found simultaneously. All patients were HEV RNA-negative. The overall HEV seroprevalence was 10.7% (24/225). The binominal logistic regression analysis of available predictors confirmed the role of vascular access and a duration of dialysis treatment over 5 years as predictors significantly associated with increased risk for HEV, and the consumption of bottled water with lower levels of HEV IgG seroprevalence among hemodialysis patients. The accumulated data are the basis for comparative analysis in subsequent trials in the same dialysis centers and for enhancing the range of screening markers used in this particular patient group. [ABSTRACT FROM AUTHOR]

Autochthonous hepatitis E (HEV) cases have been increasingly recognized and reported in Europe, caused predominantly by the zoonotic HEV genotype 3. The clinical picture is highly variable, from asymptomatic to acute severe or prolonged hepatitis in immunocompromised patients. The main route of transmission to humans in Europe is the ingestion of undercooked pork meat. Transfusion-transmitted HEV infections have also been reported. The aim of the study was to determine the HEV epidemiology and risk in the Finnish blood donor population. A total of 23,137 samples from Finnish blood donors were screened for HEV RNA from individual samples and 1012 samples for HEV antibodies. Additionally, laboratory-confirmed hepatitis E cases in 2016–2022 were extracted from national surveillance data. The HEV RNA prevalence data was used to estimate the risk of transfusion transmission of HEV in the Finnish blood transfusion setting. Four HEV RNA-positive were found, resulting in 1:5784 (0.02%) RNA prevalence. All HEV RNA-positive samples were IgM-negative, and genotyped samples represented genotype HEV 3c. HEV IgG seroprevalence was 7.4%. From the HEV RNA rate found in this study and data on blood component usage in Finland in 2020, the risk estimate for a severe transfusion-transmitted HEV infection is 1:1,377,000 components or one in every 6–7 years. In conclusion, the results indicate that the risk of transfusion-transmitted HEV (HEV TTI) in Finland is low. However, continuous follow-up of the HEV epidemiology in relation to the transfusion risk landscape in Finland is necessary, as well as promoting awareness in the medical community of the small risk for HEV TTI, especially for immunocompromised patients. [ABSTRACT FROM AUTHOR]

Viral hepatitis B and C are widely recognized problems in hemodialysis (HD) patients. There have been increasing reports of the importance of the hepatitis E virus (HEV) in recent years, but the worldwide data on the seroprevalence of HEV among them are conflicting. The aim of the present study was to assess the seroprevalence of HEV in HD patients and to analyze the predictors of seropositivity. This study was conducted in 2020 in the central part of southern Bulgaria. A total of 225 patients were enrolled. An enzyme-linked immunosorbent assay for the determination of anti-HEV IgM/IgG was used. All patients were tested for the presence of HEV RNA. Anti-HEV IgM alone and anti-HEV IgG alone were found in 6 (2.7%) and 14 (6.2%) patients, respectively, and in 4 (1.8%) patients, they were found simultaneously. All patients were HEV RNA-negative. The overall HEV seroprevalence was 10.7% (24/225). The binominal logistic regression analysis of available predictors confirmed the role of vascular access and a duration of dialysis treatment over 5 years as predictors significantly associated with increased risk for HEV, and the consumption of bottled water with lower levels of HEV IgG seroprevalence among hemodialysis patients. The accumulated data are the basis for comparative analysis in subsequent trials in the same dialysis centers and for enhancing the range of screening markers used in this particular patient group.

Background: There are many studies about the epidemiology of hepatitis E virus (HEV) in the general population, but the data about HEV infection among patients with end-stage renal disease (ESRD) give conflicting results. Although the parenteral route may be involved in the transmission of HEV infection, several investigators have suggested that fecal-oral transmission is the primary transmission mode. We aimed to identify the seroprevalence of HEV in hemodialysis (HD) patients compared to the seroprevalence of HBV and HCV infection, and examine the role of parenteral transmission.Methodology: Eighty-four patients from TBRI's HD unit who had been receiving dialysis for more than six months were involved in the study. All the patients were subjected to detailed medical history, full clinical examination, and routine investigations, including virology screening and abdominal ultrasound. HEV seropositivity was investigated by ELISA for HEV-Ab (IgG), while active viremia was assessed by RT-PCR for HEV RNA. Results: Out of the 84 patients, anti-HEV IgG antibodies were detected in five cases (6.0%). A minor (P=0.001) and a moderate (P=0.01) increase in liver echogenicity by ultrasound were significantly correlated with HEV seropositivity. Blood transfusion and HEV seropositivity did not significantly correlate (P=0.6). Neither HBsAg nor HCV-Ab was related to anti-HEV antibody seropositivity. HEV RT-PCR was only positive in one case. Conclusion: Compared to HCV (34.5%), the prevalence of HEV seropositivity was low (6%) in our patients. Parenteral transmission of HEV was less likely. HEV routine screening may help lower the related morbidity and mortality in HD patients. [ABSTRACT FROM AUTHOR]

Autochthonous hepatitis E (HEV) cases have been increasingly recognized and reported in Europe, caused predominantly by the zoonotic HEV genotype 3. The clinical picture is highly variable, from asymptomatic to acute severe or prolonged hepatitis in immunocompromised patients. The main route of transmission to humans in Europe is the ingestion of undercooked pork meat. Transfusion-transmitted HEV infections have also been reported. The aim of the study was to determine the HEV epidemiology and risk in the Finnish blood donor population. A total of 23,137 samples from Finnish blood donors were screened for HEV RNA from individual samples and 1012 samples for HEV antibodies. Additionally, laboratory-confirmed hepatitis E cases in 2016–2022 were extracted from national surveillance data. The HEV RNA prevalence data was used to estimate the risk of transfusion transmission of HEV in the Finnish blood transfusion setting. Four HEV RNA-positive were found, resulting in 1:5784 (0.02%) RNA prevalence. All HEV RNA-positive samples were IgM-negative, and genotyped samples represented genotype HEV 3c. HEV IgG seroprevalence was 7.4%. From the HEV RNA rate found in this study and data on blood component usage in Finland in 2020, the risk estimate for a severe transfusion-transmitted HEV infection is 1:1,377,000 components or one in every 6–7 years. In conclusion, the results indicate that the risk of transfusion-transmitted HEV (HEV TTI) in Finland is low. However, continuous follow-up of the HEV epidemiology in relation to the transfusion risk landscape in Finland is necessary, as well as promoting awareness in the medical community of the small risk for HEV TTI, especially for immunocompromised patients.

Objectives This study was performed to determine the seroprevalence and incidence of hepatitis E virus (HEV) infection among HIV-infected women during pregnancy and after delivery in a cohort of 200 Tanzanian women. Methods HIV-infected women participating in a study on antiretroviral therapy for the prevention of mother-to-child HIV transmission between 2006 and 2011, were tested retrospectively for anti-HEV immunoglobulin G (IgG) in plasma samples at 9 months post-partum. Anti-HEV IgG-positive patients were tested for anti-HEV IgG and immunoglobulin M (IgM) in samples from enrolment, and seroconverting women were tested for HEV RNA. Results A total of 16 women were anti-HEV IgG-positive, two of whom had seroconverted between enrolment and 9 months post-partum, with no detection of anti-HEV IgM or HEV RNA, yielding an HEV seroprevalence of 8.0% (confidence interval 5.0–12.6%) and an annual incidence rate of 1.0% (confidence interval 0.2–3.4%). CD4 cell counts were relatively high (median 403 × 10 6 /l), with no significant difference between women with and without serological signs of HEV. Conclusions An annual HEV infection incidence rate of 1% strongly indicates ongoing transmission of HEV in Tanzania and should be kept in mind for pregnant women presenting with signs of acute hepatitis. [ABSTRACT FROM AUTHOR]

Background: Hepatitis E virus (HEV), an enterically transmitted pathogen, is highly endemic in several African countries. Pregnant women are at particularly high risk for acute or severe hepatitis E. In Gabon, a central African country, the prevalence of antibodies to HEV among pregnant women is 14.1%. Recent studies have demonstrated unusual patterns of hepatitis E (chronic hepatitis, cirrhosis) among immunodeficient patients. Findings: We investigated the prevalence of antibodies to HEV among pregnant women infected with HIV-1 or HTLV-1 in Gabon. Of 243 samples collected, 183 were positive for HIV-1 and 60 for HTLV-1; 16 women (6.6%) had IgG antibodies to HEV. The seroprevalence was higher among HIV-1-infected women (7.1%) than HTLV-1-infected women (5.0%). Moreover, the HIV-1 viral load was significantly increased (p ≤ 0.02) among women with past-HEV exposure (1.3E+05 vs 5.7E+04 copies per ml), whereas no difference was found in HTLV-1 proviral load (9.0E+01 vs 1.1E+03 copies per ml). Conclusions: These data provide evidence that HIV-1-infected women are at risk for acute or severe infection if they are exposed to HEV during pregnancy, with an increased viral load. [ABSTRACT FROM AUTHOR]