2014, Number 5
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Ann Hepatol 2014; 13 (5)
Hepatitis E virus exposure in pregnant women in rural Durango, Mexico
Alvarado-Esquivel C, Sánchez-Anguiano LF, Hernández-Tinoco J
Language: English
References: 35
Page: 510-517
PDF size: 101.18 Kb.
ABSTRACT
Background and Aim. Hepatitis E virus (HEV) infection represents a risk for mortality in pregnant women.
The seroepidemiology of HEV infection in rural pregnant women in the Americas is largely unknown. The
aim of the study was to determine the seroepidemiology of anti-HEV IgG antibodies in rural pregnant women
in Durango, Mexico.
Materials and methods. The presence of anti-HEV IgG antibodies was determined
in 439 pregnant women in rural Durango, Mexico using an enzyme-linked immunoassay. Seroprevalence association
with socio-demographic, clinical and behavioral characteristics of the women was also investigated.
Results. Twenty five (5.7%; 95% CI: 3.88-8.27) of the 439 women (mean age: 24.53 ± 6.1 years) had
anti-HEV antibodies. Multivariate analysis showed that HEV seropositivity was associated with increasing age
(OR = 1.11; 95% CI: 1.03-1.20;
P = 0.004), consumption of unpasteurized cow milk (OR = 5.37; 95% CI: 1.17-
24.63;
P = 0.03), and overcrowding at home (OR = 2.36; 95% CI: 1.13-4.92;
P = 0.02). In contrast, the variables
educational level, occupation, socio-economic status, foreign travel, consumption of untreated water
and raw or undercooked meat, and raising animals did not show associations with HEV seropositivity. Exposure
to HEV was associated with the number of deliveries but not with the number of cesarean sections or
miscarriages.
Conclusions. This is the first report of seroprevalence and contributing factors for HEV infection
in rural pregnant women in the Americas, and of an association of the consumption of unpasteurized
cow milk with HEV exposure. Results of this study should be useful for designing optimal preventive measures
against HEV infection.
REFERENCES
Mori Y, Matsuura Y. Structure of hepatitis E viral particle. Virus Res 2011; 161: 59-64. doi: 10.1016/ j.virusres.2011.03.015.
Tahan V, Ozdogan O, Tozun N. Epidemiology of viral hepatitis in the Mediterranean basin. Rocz Akad Med Bialymst 2003; 48: 11-7.
Coton T, Delpy R, Hance P, Carré D, Guisset M. Autochthonous hepatitis E virus in Southeastern France. 2 cases. Presse Med 2005; 34: 651-4.
Shrestha SM. Hepatitis E in Nepal. Kathmandu Univ Med J (KUMJ) 2006;4:530-44.
Dalton HR, Bendall R, Ijaz S, Banks M. Hepatitis E: an emerging infection in developed countries. Lancet Infect Dis 2008; 8: 698-709. doi: 10.1016/S1473-3099(08)70255-X.
Wedemeyer H, Rybczynska J, Pischke S, Krawczynski K. Immunopathogenesis of hepatitis E virus infection. Semin Liver Dis 2013; 33: 71-8. doi: 10.1055/s-0033-1338118.
Dilawari JB, Singh K, Chawla YK, Ramesh GN, Chauhan A, Bhusnurmath SR, Sharma TR, et al. Hepatitis E virus: epidemiological, clinical and serological studies of north Indian epidemic. Indian J Gastroenterol 1994; 13: 44-8.
Singh S, Mohanty A, Joshi YK, Dwivedi SN, Deka D. Outcome of hepatitis E virus infection in Indian pregnant women admitted to a tertiary care hospital. Indian J Med Res 2001; 113: 35-9.
Ahmed RE, Karsany MS, Adam I. Brief report: acute viral hepatitis and poor maternal and perinatal outcomes in pregnant Sudanese women. J Med Virol 2008; 80: 1747-8. doi: 10.1002/jmv.21284.
Riveiro-Barciela M, Rodríguez-Frías F, Buti M. Hepatitis E virus: new faces of an old infection. Ann Hepatol 2013; 12: 861-70.
Cheung MC, Maguire J, Carey I, Wendon J, Agarwal K. Review of the neurological manifestations of hepatitis E infection. Ann Hepatol 2012; 11: 618-22.
Christou L, Kosmidou M. Hepatitis E virus in the Western world-a pork-related zoonosis. Clin Microbiol Infect 2013; 19: 600-4. doi: 10.1111/1469-0691.12214.
Balayan MS. Epidemiology of hepatitis E virus infection. J Viral Hepat 1997; 4: 155-65.
Alvarado-Esquivel C, Torres-Castorena A, Liesenfeld O, García-López CR, Estrada-Martínez S, Sifuentes-Álvarez A, Marsal-Hernández JF, et al. Seroepidemiology of Toxoplasma gondii infection in pregnant women in rural Durango, Mexico. J Parasitol 2009; 95: 271-4. doi: 10.1645/ GE-1829.1.
Bronfman M, Guiscafré H, Castro V, Castro R, Gutiérrez G. La medición de la desigualdad: una estrategia metodológica, análisis de las características socioeconómicas de la muestra. Arch Invest Med 1988; 19: 351-60.
Rayis DA, Jumaa AM, Gasim GI, Karsany MS, Adam I. An outbreak of hepatitis E and high maternal mortality at Port Sudan, Eastern Sudan. Pathog Glob Health 2013; 107: 66- 8. doi: 10.1179/2047773213Y.0000000076.
Yun H, Lee HJ, Cheon D, Chu C, Oh KW, Kim YT, Jee Y. Seroprevalence of hepatitis a and e viruses based on the third Korea national health and nutrition survey in Korea. Osong Public Health Res Perspect 2011; 2: 46-50. doi: 10.1016/j.phrp.2011.04.009.
Alvarez-Muñoz MT, Torres J, Damasio L, Gómez A, Tapia- Conyer R, Muñoz O. Seroepidemiology of hepatitis E virus infection in Mexican subjects 1 to 29 years of age. Arch Med Res 1999; 30: 251-4.
Bernal R R, Licona SJE. Seroepidemiology of hepatitis E in the State of Hidalgo. Rev Gastroenterol Mex 1996; 61: 233-8.
Redlinger T, O’Rourke K, Nickey L, Martinez G. Elevated hepatitis A and E seroprevalence rates in a Texas/Mexico border community. Tex Med 1998; 94: 68-71.
Pujol FH, Favorov MO, Marcano T, Esté JA, Magris M, Liprandi F, et al. Prevalence of antibodies against hepatitis E virus among urban and rural populations in Venezuela. J Med Virol 1994; 42: 234-6.
Trinta KS, Liberto MI, de Paula VS, Yoshida CF, Gaspar AM. Hepatitis E virus infection in selected Brazilian populations. Mem Inst Oswaldo Cruz 2001; 96: 25-9.
Begum N, Devi SG, Husain SA, Ashok Kumar, Kar P. Seroprevalence of subclinical HEV infection in pregnant women from north India: a hospital based study. Indian J Med Res 2009; 130: 709-13.
Traoré KA, Rouamba H, Nébié Y, Sanou M, Traoré AS, Barro N, Roques P. Seroprevalence of fecal-oral transmitted hepatitis A and E virus antibodies in Burkina Faso. PLoS One 2012; 7: e48125. doi: 10.1371/journal.pone.0048125.
El-Tras WF, Tayel AA, El-Kady NN. Seroprevalence of hepatitis E virus in humans and geographically matched food animals in Egypt. Zoonoses Public Health 2013; 60: 244-51. doi:10.1111/j.1863-2378.2012.01516.x.
Caron M, Kazanji M. Hepatitis E virus is highly prevalent among pregnant women in Gabon, central Africa, with different patterns between rural and urban areas. Virol J 2008; 5: 158. doi: 10.1186/1743-422X-5-158.
Hannachi N, Hidar S, Harrabi I, Mhalla S, Marzouk M, Ghzel H, et al. Seroprevalence and risk factors of hepatitis E among pregnant women in central Tunisia. Pathol Biol (Paris) 2011; 59: e115-8. doi: 10.1016/j.patbio.2009.06.004.
Caron M, Bouscaillou J, Kazanji M. Acute risk for hepatitis E virus infection among HIV-1-positive pregnant women in central Africa. Virol J 2012; 9: 254. doi: 10.1186/1743- 422X-9-254.
Lindemann ML, Gabilondo G, Romero B, de la Maza OM, Pérez-Gracia MT. Low prevalence of hepatitis E infection among pregnant women in Madrid, Spain. J Med Virol 2010; 82: 1666-8. doi: 10.1002/ jmv.21840.
Ibarra H, Riedemann S, Reinhardt G, Frieck P, Siegel F, Toledo C, Calvo M, et al. Prevalence of hepatitis E virus antibodies in blood donors and other population groups in southern Chile. Rev Med Chil 1997; 125: 275-8.
Zhang W, Shen Q, Mou J, Gong G, Yang Z, Cui L, et al. Hepatitis E virus infection among domestic animals in eastern China. Zoonoses Public Health 2008; 55: 291-8. doi: 10.1111/j.1863-2378.2008.01136.x.
Geng Y, Wang C, Zhao C, Yu X, Harrison TJ, Tian K, Wang Y. Serological prevalence of hepatitis E virus in domestic animals and diversity of genotype 4 hepatitis E virus in China. Vector Borne Zoonotic Dis 2010; 10: 765-70. doi: 10.1089/vbz.2009.0168.
Geng J, Wang L, Wang X, Fu H, Bu Q, Liu P, et al. Potential risk of zoonotic transmission from young swine to human: seroepidemiological and genetic characterization of hepatitis E virus in human and various animals in Beijing, China. J Viral Hepat 2011; 18:e583-90. doi: 10.1111/ j.1365-2893.2011.01472.x.
Bendall R, Ellis V, Ijaz S, Ali R, Dalton H. A comparison of two commercially available anti-HEV IgG kits and a re-evaluation of anti-HEV IgG seroprevalence data in developed countries. J Med Virol 2010; 82: 799-805. doi: 10.1002/ jmv.21656.
Wenzel JJ, Preiss J, Schemmerer M, Huber B, Jilg W. Test performance characteristics of Anti-HEV IgG assays strongly influence hepatitis E seroprevalence estimates. J Infect Dis 2013; 207: 497-500. doi: 10.1093/ infdis/jis688.