Prevalence of Hepatitis E virus antibody in a non endemic population - prospective study

Prevalência da Hepatite E em população não endémica - estudo prospectivo

 

S. Folgado Alberto¹, S. Pires¹, J. Félix¹, A. Figueiredo¹, L. Silva², M. Franco², G. de Sousa², J. Ramos de Deus¹

 

Abstract

BACKGROUND hepatitis E virus (HEV) infection occurs as large outbreaks in endemic countries. In Europe, it is generally associated with travelling to those countries. However, sporadic cases of HEV infection without previous history of travelling have been appearing.

AIM: To identify the prevalence of HEV antibodies in our population as a non endemic country.

METHODS: 237 patients were selected (152 patients from the gastroenterology department and 85 healthy blood donors). Blood samples were collected to measure total HEV-antibody (HEV-ab). A questionnaire that included personal, epidemiologic and biochemical data was completed.

RESULTS: 10 individuals (7 patients – 4.6% and 3 healthy donors – 3.5%) were positive for anti-HEV. Two patients from the first group had a travelling history but the other 5 didn’t. No other risk factors were found. A parametric test for identity of proportions was used: there was no differences between the characteristics of the two groups and the positivity for anti-HEV.

CONCLUSION: As a non-endemic country, we found that 4.2% of our population have anti-HEV virus antibodies. The majority (3.4%) of them weren’t related to travelling or to other epidemiologic risk factors. The results are similar to that found around Europe. According to that, in Portugal we may need to start considering testing for HEV in patients with jaundice or acute hepatitis.

 

Resumo

INTRODUÇÃO: O vírus da Hepatite E (VHE) ocorre, geralmente, em grandes surtos em países endémicos.

Na Europa, os casos de VHE estão associados a viajantes de países endémicos. No entanto, estudos recentes descrevem casos esporádicos de VHE em indivíduos sem história de viagens a áreas endémicas.

Objectivo: identificar a taxa de prevalência do VHE na nossa população, como país não-endémico.

MATERIAL E MÉTODOS: Foram seleccionados 237 indivíduos (152 doentes do departamento de gastrenterologia e 85 dadores de sangue saudáveis): para colheita de amostras para doseamento do Ac total VHE. Foi preenchido um questionário com dados pessoais, epidemiológicos e laboratoriais RESULTADOS: 10 doentes foram positivos para o Ac-VHE (7 do grupo de doentes – 4,6% e 3 do grupo de dadores saudáveis – 3,5%). Dois dos sete doentes do primeiro grupo tinham história de viagens a países endémicos. Não se encontraram outros factores de risco.

Um estudo paramétrico para identidade de proporções mostrou que as populações eram idênticas e tinham um valor de seropositividade semelhante.

Conclusão: Enquanto país não endémico 4,2% da nossa população era seropositiva para VHE. Não havia factores de risco epidemiológicos ou história de viagens na maioria dos casos (3,4%) Perante o aumento de resultados em toda a Europa, similares os deste estudo, coloca-se a questão da necessidade de despistar VHE nos doentes com icterícia ou hepatite aguda.

 

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¹Gastroenterology department;

²Clinical pathology department

 

Correspondência:

Sara Folgado Alberto

Department of Gastroenterology, Hospital Fernando Fonseca IC-19, Amadora

2720-276 Amadora, Portugal

sarafalberto@gmail.com

 

Recebido para publicação: 16/01/2009

Aceite para publicação: 21/09/2009