Seroepidemiology of Hepatitis E Virus Infection in General Population in Rural Durango,Mexico

Background:

The seroepidemiology of hepatitis E virus (HEV) infection in rural areas in Mexico has been poorly studied.

Objectives:

The aim of the study was to determine the seroprevalence and correlates of anti-HEV IgG antibodies in adults in rural areas in Durango, Mexico.

Materials and Methods:

We performed a cross-sectional study to determine the frequency of anti-HEV IgG antibodies in 273 adults living in rural Durango, Mexico using an enzyme-linked immunoassay. In addition, we searched for an association of HEV exposure with the socio-demographic and behavioral characteristics of the subjects studied.

Results:

One hundred (36.6%) of the 273 rural adults (mean age: 39.85 ± 17.15 years) had anti-HEV IgG antibodies. Multivariate analysis of socio-demographic and behavioral characteristics of the participants showed that HEV exposure was associated with increasing age (OR = 1.04; 95% CI: 1.04-1.05; P < 0.001), consumption of untreated water (OR = 1.92; 95% CI: 1.06-3.46; P = 0.03), and availability of water at home (OR = 1.87; 95% CI: 1.07-3.27; P = 0.02). In contrast, other socio-demographic and behavioral characteristics including educational level, occupation, socio-economic status, foreign travel, consumption of unwashed raw fruits, consumption of raw or undercooked meat and raising animals did not show associations with HEV exposure.

Conclusions:

The seroprevalence of HEV infection found in rural Durango is higher than those reported in other Mexican populations. Consumption of untreated water is an important factor for HEV exposure in rural areas in Durango. The correlates of HEV seropositivity found in the present study can be used for an optimal planning of preventive measures against HEV infection.     

Vaccination Rate and Seroepidemiology of Hepatitis A in Chronic-Hepatitis-B-Infected Individuals in the Korean Army

Background/Aims

Vaccination against hepatitis A virus (HAV) is recommended for patients with chronic hepatitis B (CHB), since they are potentially at an increased risk of HAV-related morbidity and mortality. However, little is known about the adherence to these recommendations in the community. This study evaluated the current vaccination status and immunity against HAV among Korean military soldiers with CHB.

Methods

We performed a prospective study of Korean military soldiers from August 2008 to January 2009. We enrolled 96 soldiers with CHB on a consecutive basis. We assessed their vaccination history and the presence of anti-HAV immunoglobulin G (IgG).

Results

The HAV vaccination rate of the soldiers enrolled in our study was 2% (2 of the 96 soldiers). The seroprevalence rates of anti-HAV IgG among military soldiers without a vaccination history were 0%, 50%, and 100% for those aged 19-29 years (n=71), 30-39 years (n=8), and 40 years or older (n=15), respectively (p<0.001).

Conclusions

The HAV vaccination rate is very low among military soldiers. Public health efforts aimed at raising awareness about HAV vaccination in patients with CHB should be strongly encouraged.     

Seroepidemiology of hepatitis A virus in Kuwait

AIM： To find the current seroepidemiology of hepatitis A virus （HAV） in Kuwait. METHODS： A total of 2851 Kuwaitis applying for new jobs were screened.RESULTS： HAV-positive cases were 28.8%; 59% were males and 41% were females. The highest prevalence was in the Ahmadi area. High prevalence was among the group of non-educated rather than educated parents. This is the first study in Kuwait demonstrating the shifting epidemiology of HAV. CONCLUSION： This study reflects the need of the Kuwaiti population for an HAV vaccine.     

1990～2001年上海市区幽门螺杆菌血清流行病学比较

目的：比较1990－2001年上海市区幽门螺杆菌（H.pylori)血清流行病学的改变，探讨H.pylori感染的危险因素。方法：2001年6－10月，应用检测H.pylori血清IgG抗体的酶免疫试剂盒，以酶联免疫吸附测定（ELISA）法检测上海市区1557位居民的血清标本，结合问卷形式调查市民的就餐、居住等生活环境因素，985人完成问卷调查；比较1990年和2001年2次调查的结果。以队列研究和多变量逐步Logistic回归方法分析H.pylori感染的危险因素。结果：2001年市区总体H.pylori阳性率为58.3%，高于1990年的42.7%(P=0.001)，低于1990年郊区的61.0%(P=0.116)。1－9岁和10－19岁年龄组的感染率与11年前相比无显著改变（29.7%、39.6%比27.4%、42.7%,P=0.683和P=0.707)，仍低于11年前郊区的水平（56.4%和57.3%,P=0.001和P=0.031)。70岁以上年龄组的感染率与11年前相比亦无显著差异（P=0.113)。30－69岁年龄组的H.pylori感染率较11年前显著升高（P＜0.05),20-69岁年龄组的H.pylori感染率与1990年郊区水平相当（P=0.276-0.935)。危险因素分析和逐步Logistic回归结果显示，年龄、家庭成员数＞3、户外聚餐等是H.pylori感染的危险因素。结论：我国城市经济发展、人口流动等引发的市民生活方式和环境改变可能影响H.pylori的流行病学特征，对H.pylori的防治工作提出了新的挑战。     

Seroepidemiology of hepatitis B virus infection: analysis of mass screening in Hawaii

Background  Although hepatitis B seroprevalence has been studied extensively in California and New York, detailed information for other high-risk areas in the United States is lacking. To study current prevalence and risk for hepatitis B virus (HBV) infection in Hawaii, we analyzed cross-sectional data from Hawaii residents screened between July 2003 and April 2006. Methods  We retrospectively reviewed the screening records of 3,989 participants recruited at health fairs and clinics. Prevalence and risk factors for HBV infection were estimated using univariate and multivariate logistic regression models. Results  Total prevalence of hepatitis B surface antigen (HBsAg) was 3.6%. Gender, age, and ethnicity were independently associated with HBsAg seropositivity. In a multivariate logistic regression model, males were at increased risk for HBsAg compared with females (odds ratio [OR] = 1.53, 95% confidence interval [CI]: 1.09–2.16) and persons aged 70 years or older were less likely to test positive than those younger than 30 (OR = 0.25, 95% CI: 0.11–0.61). In addition, multivariate ORs of HBsAg seropositivity were 3.24 (95% CI: 1.04–10.09), 4.13 (95% CI: 1.66–10.29), and 7.47 (95% CI: 2.52–22.11) for Vietnamese, Chinese, and Pacific Islanders, respectively, compared with Whites. Conclusions  This study furthers current knowledge of HBV epidemiology in areas with large populations of high-risk immigrants and demonstrates the relevance of screening programs for hepatitis B.     

Seroepidemiology of hepatitis A in patients with chronic liver disease

Hepatitis A virus (HAV) rarely causes fulminant hepatic failure in the general population. Yet it is a cause of significant morbidity and mortality in patients with chronic liver disease (CLD), in whom routine HAV vaccination is recommended. However, studies of HAV seroprevalence and exposure predictors in populations with CLD are scarce. We have studied a cohort of 473 patients with various causes of CLD between July 2000 and June 2002. Patients were stratified on the basis of age, gender, ethnicity and aetiology of liver disease. The HAV seroprevalence in patients with CLD was compared with that in the general population. We used a logistic regression analysis to identify independent predictors of HAV exposure. Of the 473 patients studied, HAV seroprevalence was available for 454 individuals. HCV, HBV, alcohol, and HCV and alcohol were the causes of CLD in 337, 72, 37 and eight patients, respectively. The overall HAV seroprevalence was 55% in the studied cohort. The age-stratified HAV prevalence for ages 21-30, 31-40, 41-50, 51-60, 61-70 and greater than 70 years was 44, 51, 44, 63, 65 and 64%, respectively. Hispanic ethnicity, Asian ethnicity, alcohol use and ages of 51-70 years were found to be independent predictive variables of prior exposure to HAV. HAV infection in patients with CLD causes considerable morbidity and mortality. We demonstrated that age-stratified seroprevalence of HAV in patients with CLD of various aetiologies is significantly higher than that of the general population, and identified several independent predictors of HAV prior exposure.     

2007年和2008年宁夏鼠疫疫源地高危人群血清流行病学调查

目的 了解2007年和2008年宁夏鼠疫自然疫源地人群鼠疫F1抗体水平和分布情况.方法 采集宁夏鼠疫发生地和动物鼠疫流行疫源地的5个市(县)居民血样718份作为调查对象,采集非疫区居民血样475份作为对照组.用间接血凝试验、胶体金试验、酶联免疫吸附试验3种方法检测人群鼠疫F1抗体.两种以上方法检测为阳性者,判定为阳性血样;抗体滴度没有达到阳性判定标准者,判定为可疑血样.结果 检测718份血样,检出阳性血样9份(滴度在1:16～1:64),阳性率为1.25%(9/718);可疑血样28份,检出率为3.90%(28/718).3种方法检测非疫区人群血样475份,全部为阴性.疫区和非疫区人群血清鼠疫F1抗体阳性率比较,差异有统计学意义(χ2=4.44,P<0.05).间接血凝试验、胶体金试验、酶联免疫吸附试验3种检测方法的阳性率[1.25%(9/718)、1.25%(9/718)、2.51%(18/718)]比较,差异无统计学意义(χ2=1.91,P>0.05).结论 宁夏鼠疫自然疫源地内尚存在一定比例的鼠疫F1抗体阳性人群,均分布在近几年有动物鼠疫流行的地区.     

Changing patterns of hepatitis A prevalence within the Saudi population over the last 18 years

AIM： To determine the seroprevalence of Hepatitis A （HAV） amongst Saudi children and compare it with previously reported prevalence data from the same population. METHODS： A total of 1357 students were randomly selected between the ages of 16 and 18 years （689 males and 668 females） from three different regions of Saudi Arabia （Madinah, AI-Qaseem, and Aseer） and tested for anti-HAV-IgG.RESULTS： The overall prevalence of anti-HAV-IgG among the study population was 18.6%. There was no difference between males and females but there was a significant difference in the seroprevalence （P = 0.0001） between the three different regions, with Madinah region showing the highest prevalence （27.4%）. When classified according to socioeconomic status, lower class students had a prevalence of 36.6%, lower middle class 16.6%, upper middle class 9.6%, and upper class 5.9% （P = 0.0001）. Comparing the current study results with those of previous studies in 1989 and 1997 involving the same population, there was a marked reduction in the overall prevalence of HAV from 52% in 1989, to 25% in 1997, to 18.6% in 2008 （P 〈 0.0001）.CONCLUSION： Over the last 18 years, there has been a marked decline in the prevalence of HAV in Saudi children and adolescents. The current low prevalence rates call for strict adherence to vaccination policies in high-risk patients and raises the question of a universal HAV vaccination program.     

Risk Factors of HCV Seroconversion in Hemodialysis Patients in Tabriz,Iran

Background:

Hepatitis C virus (HCV) infection is a significant health concern in patients with end-stage renal disease under dialysis. Epidemiological studies have reported a prevalence rate of 5.5-55.9% for this condition in Iran.

Objectives:

We evaluated the risk factors for HCV infection and seroconversion in hemodialysis patients.

Patients and Methods:

A retrospective analysis was performed on 455 hemodialysis patients from each of the five dialysis units in Tabriz, northwest Iran. Possible risk factors for HCV infection and seroconversion were evaluated.

Results:

A total of 37 patients were HCV positive (8.1% of the study population) and seroconversion occurred in 18 of them during the dialysis treatment (3.95% of the study population). History of renal transplantation (44.4%, P < 0.0001), surgical intervention (except for renal transplantation and AV fistula placement) (94.4%, P = 0.03), and mean duration of dialysis (106.06 ± 55.519, P < 0.0001) had strong statistically significant associations with the seroconversion.

Conclusions:

The current study indicates increased risk for HCV infection in patients under dialysis and its relation with the mean duration of hemodialysis, history of renal transplantation and surgical intervention. Considering the immune deficiency in these patients, intense education to both patients and medical staff will be beneficial.     

Is Evaluation of Hepatitis A Immunity Required or Not?

Hepatitis A virus (HAV) infection is one of the most common causes of acute hepatitis and it is a serious health problem worldwide. HAV infection is a vaccine preventable disease that can produce the lifelong immunity seen in many developed countries with the vaccination schedule administered to children; however this vaccine is not used in developing countries at the present time. Improvements in food and water hygiene have caused a displacement of hepatitis A infection from children to adults which has increased mortality rates. Therefore evaluation of HAV immunity levels can help health authorities develop polices for prophylaxis especially in developing countries.     

齐齐哈尔市某高校人群血清乙型肝炎病毒流行病学调查*

目的了解齐齐哈尔市某高校各类人群乙型肝炎病毒血清流行病学感染状况。方法在2000名学生、200名教师、100名教辅人员、100名后勤人员和100名机关人员取血清,采用ELISA法检测HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc。结果在2500人中,检出HBV标记物阳性232人（9.3%）;后勤人员血清HBsAg携带率为13%,显著高于其他各类人群 （x²=32.6, P<0.05）;其他各类人群血清HBsAg阳性率在7.0%~9.5%之间,无显著性差别（P>0.05）;所有被检测人员血清抗-HBs阳性率为50.3%,各组之间无明显统计学差别（x²=5.62,P>0.05）。结论高校各类人群乙型肝炎血清学指标检出率因群体不同而不同,需加强乙型肝炎防治教育,加强疫苗接种和卫生保健意识教育。     

Changing pattern of hepatitis a virus epidemiology in an area of high endemicity

Background

Continuous assessment of hepatitis A virus (HAV) seroepidemiology is a useful tool to control the risk of infection.

Objectives

This study aimed to evaluate the changing patterns of anti-HAV seroprevalence in a population,which isgenerally considered to be anarea ofhigh endemicity.

Patients and Methods

Overall, the results of 3349 sera collected during the period 2005-2008 from patients attending the University Hospital of Cagliari, Italy were studied; their mean age was 52.7 years, (s + 16.22). Patients with liver disease were excluded from the study. Age specific seroprevalence results were compared with those observed in similar previous studies carried out in the same area.

Results

The overall prevalence of anti-HAV was 74.6% with consistently lower values in subjects younger than 40 years (17.5%; P < 0.0001) particularly in those under 30 years of age (8.9%, CI 5.8-11.9). A significant declining trend in age specific seroprevalence has been foundin people under 30 years;61% in 1988, 33% in 1995 and 8.9% in 2005-2008.

Conclusions

Our findings show that a significant decline inherd immunity has occurred in the last 20 years as a consequence of lower HAV circulation due to improvementsin socio-economical and hygienic conditions. Adolescents and young adults are becoming increasingly susceptible to HAV infections, as recent outbreaks of acute HAV hepatitis have occurred. Persistent environmental monitoring and the implementation of prevention measures must be considered in order to contain the risk related to this epidemiological shift.     

Epidemiology of hepatitis C in Croatia in the European context

We analyzed prevalence, risk factors and hepatitis C virus (HCV) genotype distribution in different population groups in Croatia in the context of HCV epidemiology in Europe, with the aim to gather all existing information on HCV infection in Croatia which will be used to advise upon preventive measures. It is estimated that 35000-45000 of the Croatian population is chronically infected with HCV. Like in other European countries, there have been changes in the HCV epidemiology in Croatia over the past few decades. In some risk groups (polytransfused and hemodialysis patients), a significant decrease in the HCV prevalence was observed after the introduction of routine HCV screening of blood/blood products in 1992. Injecting drug users (IDUs) still represent a group with the highest risk for HCV infection with prevalence ranging from 29% to 65%. Compared to the prevalence in the Croatian general population (0.9%), higher prevalence rates were found in prison populations (8.3%-44%), human immunodeficiency virus-infected patients (15%), persons with high-risk sexual behavior (4.6%) and alcohol abusers (2.4%). Low/very low prevalence was reported in children and adolescents (0.3%) as well as in blood donors (0%-0.009%). In addition, distribution of HCV genotypes has changed due to different routes of transmission. In the general population, genotypes 1 and 3 are most widely distributed (60.4%-79.8% and 12.9%-47.9%, respectively). The similar genotype distribution is found in groups with high-risk sexual behavior. Genotype 3 is predominant in Croatian IDUs (60.5%-83.9%) while in the prison population genotypes 3 and 1 are equally distributed (52.4% and 47.6%). Data on HCV prevalence and risk factors for transmission are useful for implementation of preventive measures and HCV screening.     

福建省不同人群中戊型肝炎病毒感染的血清流行病学调查分析

目的了解福建省不同人群中戊型肝炎病毒的感染情况。方法收集普通人群血清2209份,职业危险人群血清1722份,应用双抗原夹心ELISA法检测抗HEV抗体。普通人群由健康体检人员和健康献血者组成,职业危险人群由养鸡场或养猪场的饲养员、屠宰工、兽医、厨师或从事鸡鸭批发者组成,使用SPSS软件比较不同人群的感染率。结果普通人群HEV的阳性率为23.3%,职业危险人群HEV阳性率为33.3%(χ2=48.51,P<0.001)。在职业危险人群中与鸡密切接触者HEV的阳性率显著高于与猪密切接触者。HEV阳性率有随年龄的增长而上升的趋势,在普通人群中男、女性HEV阳性率无显著性差异(P>0.05)。在职业危险人群中男性HEV阳性率显著高于女性。结论普通人群HEV的感染率较高,提示HEV亚临床感染的存在。与猪、鸡密切接触者HEV阳性率高于普通人群,这些数据进一步证明了HEV可能是一种人兽共患病的假设。     

Seroprevalence study of hepatitis A virus in Fars province, southern Iran

Background

There are several studies on seroprevalence of hepatitis A virus (HAV) in adults in the Middle East.

Objectives

To determine seroprevalence of HAV among adult population in Fars province, southern Iran.

Patients and Methods

In a cross-sectional study, we checked anti-HAV antibody (IgG) in subjects refereed to our health care centers to perform laboratory tests before getting married between March 2008 and March 2009. Age-specific seroprevalence was also determined. Some risk factors like level of education, type of residence, job, numbers of family members, and access to treated water were also evaluated in these participants.

Results

From 1050 subjects studied, 927 (88.2%) had ant-HAV antibody; 123 (11.8%) were antibody negative. Among subjects aged < 20 years, the anti-HAV seroprevalence was the lowest (79.3%) followed by subjects aged 20-30 years (91.3%) and those > 30 years (99%) (p = 0.01). 85.1% of studied individuals in urban areas had anti-HAV IgG while 95.9% of subjects in rural regions were anti-HAV positive (p = 0.001). The seroprevalence of HAV antibody was significantly associated with number of family members (p = 0.001).

Conclusion

HAV is highly prevalent in our region especially in rural areas. It is better to vaccinate the children for HAV by the time they receive HBV vaccine or when they are five years.     

Effects of alcohol intake and low Km aldehyde dehydrogenase on hepatic function in a high hepatitis C virus-prevalent Japanese island population

In Asians from the Pacific rim countries, alcohol sensitivity has been attributed mainly to a highly prevalent polymorphism in low Km aldehyde dehydrogenase (ALDH2). Chronic alcohol abuse may accelerate or aggravate the liver injury in chronic hepatitis C virus (HCV)-infected subjects. In this study, we examined the relationships among alcohol intake, ALDH2 genotypes, and liver injury in a high HCV-prevalent Japanese native island population. The ALDH2 genotypes are significantly associated with drinking habits. In HCV RNA positive subjects, serum alanine aminotransferase (ALT), as well as aspartate transaminase (AST) and gamma-glutamyl transpeptidase (GGT), were significantly higher in habitual drinkers than in nonhabitual drinkers. In male habitual drinkers, the ALDH2*1/*1 subjects had higher liver necroinflammatory scores than the ALDH2*1/*2 subjects in all groups classified as: I, anti-HCV-seronegative; II, anti-HCV-seropositive with negative HCV RNA; and III, HCV RNA positive, although scores for the latter two groups were not statistically significant because of limited sample size. It was suggested that the liver function might be affected by the interaction between the ALDH2 genotypes and alcohol intake. These findings indicate that HCV-infected ALDH2*1/*1 habitual drinkers are the major target for the prevention of alcoholic liver diseases.     

Laboratory characteristics of recent hepatitis A in Korea:Ongoing epidemiological shift

AIM:To evaluate seroprevalence of hepatitis A virus (HAV) antibody and investigate demographic,clinical,and laboratory features of recent cases in Korea.METHODS:For the evaluation of hepatitis A seroprevalence,we analyzed the data from 3127 subjects including,healthcare workers and patients who visited Konkuk University Hospital,a secondary referral center,from January to October 2009.The sera with positive IgM were excluded from seroprevalence data for total HAV antibody.We retrospectively reviewed the electronic medical records of 419 patients with HAV,who were diagnosed by the presence of serum IgM antibodies against HAV.All patients presented at Konkuk University Hospital between August 2005 and September 2008.RESULTS:Among 3127 sera tested,1428 (45.7%)were positive for anti-HAV antibody.The seroprevalence was very low in teenagers or those in their twenties,increased in those in their thirties,and was > 90% in older patients.In children younger than 10 years,seroprevalence was increased again.Most patients with HAV hepatitis were in their twenties and thirties.The γ-glutamyl transpeptidase increased with age and was significantly higher in patients older than 30 years.Indicators of severity,such as decreased albumin and increased bilirubin,were also more prominent in the older age group;however,the leukocyte count was higher and the frequency of leukopenia was lower in younger patients than in older adults.CONCLUSION:There has been an apparent epidemiological shift in HAV seroprevalence and a change in the peak age of HAV hepatitis.This study could provide baseline data of recent hepatitis A in Asia.     

Age-specific seroprevalence of anti-hepatitis a antibody among 1-30 years old population of savadkuh, mazandaran, iran with literature review

Background

To determine age-specific seroprevalence rates of hepatitis A virus (HAV) immunoglobulin G (IgG) antibody in Savadkuh district, Mazandaran province, north of Iran, as well as to compare the collected data with earlier seroprevalence studies in the region and Iran in order to draw a proper epidemiological pattern for HAV infection in the country.

Objectives

This study aimed to assess an age-specific HAV seroprevalence among 1- to 30-yearold people in Savadkuh, a less developed district of Mazandaran province, north of Iran.

Patients and Methods

The study participants were 984 subjects who aged from one to 30 years and were residents of rural and urban areas of Savadkuh. They were selected using cluster sampling method and divided into five age groups: 1-2.9 (316 cases), 3-6.9 (254 cases), 7-10.9 (201 cases), 11-17.9 (115 cases), and 18-30 (98 cases). Anti-HAV antibody was measured by ELISA method. Seroprevalence rates among different age groups and their relationship to residency, educational levels of parents, water supply, and waste water disposal system was analyzed using chi-squared test.

Results

Overall seroprevalence rate was 19.20 % with no significant difference between rural and urban residents. The seroprevalence rates increased significantly with age: from 5.7 % in age group 1-2.9 year to 34.8 % in adolescents, and to 68.4 % among young adults (P < 0.0001); regardless of significant differences in educational levels among parents of residents in two areas it did not affect seroprevalence rates. Findings of this study and reviewing other reports from the region and the country suggest an epidemiological shift towards lower rates of anti-HAV antibody seroprevalence.

Conclusions

It appears that anti-HAV antibody seroprevalence rate has been declining among Iranians and thereby more children would be susceptible to this infection. This would necessitate revising current strategies of preventative measures in Mazandaran and Iran.