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Hepatitis E Seroprevalence in Europe: A Meta-Analysis

Identifieur interne : 000053 ( Main/Exploration ); précédent : 000052; suivant : 000054

Hepatitis E Seroprevalence in Europe: A Meta-Analysis

Auteurs : Johannes Hartl ; Benjamin Otto ; Richie Guy Madden ; Glynn Webb ; Kathy Louise Woolson ; Levente Kriston ; Eik Vettorazzi ; Ansgar W. Lohse ; Harry Richard Dalton ; Sven Pischke

Source :

RBID : PMC:4997573

Abstract

There have been large numbers of studies on anti-HEV IgG seroprevalence in Europe, however, the results of these studies have produced high variability of seroprevalence rates, making interpretation increasingly problematic. Therefore, the aim of this study was to develop a clearer understanding of anti-HEV IgG seroprevalence in Europe and identify risk groups for HEV exposure by a meta-analysis of published studies. Methods: All European HEV-seroprevalence studies from 2003 to 2015 were reviewed. Data were stratified by assay, geographical location, and patient cohort (general population, patients with HIV, solid-organ transplant recipients, chronic liver disease patients, and individuals in contact with swine/wild animals). Data were pooled using a mixed-effects model. Results: Four hundred thirty-two studies were initially identified, of which 73 studies were included in the analysis. Seroprevalence estimates ranged from 0.6% to 52.5%, increased with age, but were unrelated to gender. General population seroprevalence varied depending on assays: Wantai (WT): 17%, Mikrogen (MG): 10%, MP-diagnostics (MP): 7%, DiaPro: 4%, Abbott 2%. The WT assay reported significantly higher seroprevalence rates across all cohorts (p < 0.001). Individuals in contact with swine/wild animals had significantly higher seroprevalence rates than the general population, irrespective of assay (p < 0.0001). There was no difference between any other cohorts. The highest seroprevalence was observed in France (WT: 32%, MP: 16%) the lowest in Italy (WT: 7.5%, MP 0.9%). Seroprevalence varied between and within countries. The observed heterogeneity was attributed to geographical region (23%), assay employed (23%) and study cohort (7%). Conclusion: Seroprevalcence rates primarily depend on the seroassy that is used, followed by the geographical region and study cohort. Seroprevalence is higher in individuals exposed to swine and/or wild animals, and increases with age.


Url:
DOI: 10.3390/v8080211
PubMed: 27509518
PubMed Central: 4997573


Affiliations:


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Le document en format XML

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<email>richie@forfey.com</email>
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<email>glynn.webb@students.pcmd.ac.uk</email>
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<name sortKey="Kriston, Levente" sort="Kriston, Levente" uniqKey="Kriston L" first="Levente" last="Kriston">Levente Kriston</name>
<affiliation>
<nlm:aff id="af3-viruses-08-00211">Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany;
<email>l.kriston@uke.de</email>
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<author>
<name sortKey="Vettorazzi, Eik" sort="Vettorazzi, Eik" uniqKey="Vettorazzi E" first="Eik" last="Vettorazzi">Eik Vettorazzi</name>
<affiliation>
<nlm:aff id="af4-viruses-08-00211">Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany;
<email>e.vettorazzi@uke.de</email>
</nlm:aff>
</affiliation>
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<name sortKey="Lohse, Ansgar W" sort="Lohse, Ansgar W" uniqKey="Lohse A" first="Ansgar W." last="Lohse">Ansgar W. Lohse</name>
<affiliation>
<nlm:aff id="af1-viruses-08-00211">First Medical Department, University Medical Center Hamburg-Eppendorf, University Hospital Hamburg Eppendorf (UKE), 20246, Hamburg, Germany;
<email>b.otte@uke.de</email>
(B.O.);
<email>alohse@uke.de</email>
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<name sortKey="Dalton, Harry Richard" sort="Dalton, Harry Richard" uniqKey="Dalton H" first="Harry Richard" last="Dalton">Harry Richard Dalton</name>
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<nlm:aff id="af2-viruses-08-00211">Royal Cornwall Hospital Trust and European Centre for Environment and Human Health, University of Exeter, Truro TR1 3HD, UK;
<email>richie@forfey.com</email>
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<email>glynn.webb@students.pcmd.ac.uk</email>
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<email>b.otte@uke.de</email>
(B.O.);
<email>alohse@uke.de</email>
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<nlm:aff id="af2-viruses-08-00211">Royal Cornwall Hospital Trust and European Centre for Environment and Human Health, University of Exeter, Truro TR1 3HD, UK;
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<email>glynn.webb@students.pcmd.ac.uk</email>
(G.W.);
<email>kathy.woolson@nhs.net</email>
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<email>Harry.Dalton@rcht.cornwall.nhs.uk</email>
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<title xml:lang="en" level="a" type="main">Hepatitis E Seroprevalence in Europe: A Meta-Analysis</title>
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<name sortKey="Hartl, Johannes" sort="Hartl, Johannes" uniqKey="Hartl J" first="Johannes" last="Hartl">Johannes Hartl</name>
<affiliation>
<nlm:aff id="af1-viruses-08-00211">First Medical Department, University Medical Center Hamburg-Eppendorf, University Hospital Hamburg Eppendorf (UKE), 20246, Hamburg, Germany;
<email>b.otte@uke.de</email>
(B.O.);
<email>alohse@uke.de</email>
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<name sortKey="Otto, Benjamin" sort="Otto, Benjamin" uniqKey="Otto B" first="Benjamin" last="Otto">Benjamin Otto</name>
<affiliation>
<nlm:aff id="af1-viruses-08-00211">First Medical Department, University Medical Center Hamburg-Eppendorf, University Hospital Hamburg Eppendorf (UKE), 20246, Hamburg, Germany;
<email>b.otte@uke.de</email>
(B.O.);
<email>alohse@uke.de</email>
(A.W.L.);
<email>s.pischke@uke.de</email>
(S.P.)</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Madden, Richie Guy" sort="Madden, Richie Guy" uniqKey="Madden R" first="Richie Guy" last="Madden">Richie Guy Madden</name>
<affiliation>
<nlm:aff id="af2-viruses-08-00211">Royal Cornwall Hospital Trust and European Centre for Environment and Human Health, University of Exeter, Truro TR1 3HD, UK;
<email>richie@forfey.com</email>
(R.G.M.);
<email>glynn.webb@students.pcmd.ac.uk</email>
(G.W.);
<email>kathy.woolson@nhs.net</email>
(K.L.W.);
<email>Harry.Dalton@rcht.cornwall.nhs.uk</email>
(H.R.D.)</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Webb, Glynn" sort="Webb, Glynn" uniqKey="Webb G" first="Glynn" last="Webb">Glynn Webb</name>
<affiliation>
<nlm:aff id="af2-viruses-08-00211">Royal Cornwall Hospital Trust and European Centre for Environment and Human Health, University of Exeter, Truro TR1 3HD, UK;
<email>richie@forfey.com</email>
(R.G.M.);
<email>glynn.webb@students.pcmd.ac.uk</email>
(G.W.);
<email>kathy.woolson@nhs.net</email>
(K.L.W.);
<email>Harry.Dalton@rcht.cornwall.nhs.uk</email>
(H.R.D.)</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Woolson, Kathy Louise" sort="Woolson, Kathy Louise" uniqKey="Woolson K" first="Kathy Louise" last="Woolson">Kathy Louise Woolson</name>
<affiliation>
<nlm:aff id="af2-viruses-08-00211">Royal Cornwall Hospital Trust and European Centre for Environment and Human Health, University of Exeter, Truro TR1 3HD, UK;
<email>richie@forfey.com</email>
(R.G.M.);
<email>glynn.webb@students.pcmd.ac.uk</email>
(G.W.);
<email>kathy.woolson@nhs.net</email>
(K.L.W.);
<email>Harry.Dalton@rcht.cornwall.nhs.uk</email>
(H.R.D.)</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kriston, Levente" sort="Kriston, Levente" uniqKey="Kriston L" first="Levente" last="Kriston">Levente Kriston</name>
<affiliation>
<nlm:aff id="af3-viruses-08-00211">Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany;
<email>l.kriston@uke.de</email>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Vettorazzi, Eik" sort="Vettorazzi, Eik" uniqKey="Vettorazzi E" first="Eik" last="Vettorazzi">Eik Vettorazzi</name>
<affiliation>
<nlm:aff id="af4-viruses-08-00211">Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany;
<email>e.vettorazzi@uke.de</email>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Lohse, Ansgar W" sort="Lohse, Ansgar W" uniqKey="Lohse A" first="Ansgar W." last="Lohse">Ansgar W. Lohse</name>
<affiliation>
<nlm:aff id="af1-viruses-08-00211">First Medical Department, University Medical Center Hamburg-Eppendorf, University Hospital Hamburg Eppendorf (UKE), 20246, Hamburg, Germany;
<email>b.otte@uke.de</email>
(B.O.);
<email>alohse@uke.de</email>
(A.W.L.);
<email>s.pischke@uke.de</email>
(S.P.)</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Dalton, Harry Richard" sort="Dalton, Harry Richard" uniqKey="Dalton H" first="Harry Richard" last="Dalton">Harry Richard Dalton</name>
<affiliation>
<nlm:aff id="af2-viruses-08-00211">Royal Cornwall Hospital Trust and European Centre for Environment and Human Health, University of Exeter, Truro TR1 3HD, UK;
<email>richie@forfey.com</email>
(R.G.M.);
<email>glynn.webb@students.pcmd.ac.uk</email>
(G.W.);
<email>kathy.woolson@nhs.net</email>
(K.L.W.);
<email>Harry.Dalton@rcht.cornwall.nhs.uk</email>
(H.R.D.)</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Pischke, Sven" sort="Pischke, Sven" uniqKey="Pischke S" first="Sven" last="Pischke">Sven Pischke</name>
<affiliation>
<nlm:aff id="af1-viruses-08-00211">First Medical Department, University Medical Center Hamburg-Eppendorf, University Hospital Hamburg Eppendorf (UKE), 20246, Hamburg, Germany;
<email>b.otte@uke.de</email>
(B.O.);
<email>alohse@uke.de</email>
(A.W.L.);
<email>s.pischke@uke.de</email>
(S.P.)</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="af2-viruses-08-00211">Royal Cornwall Hospital Trust and European Centre for Environment and Human Health, University of Exeter, Truro TR1 3HD, UK;
<email>richie@forfey.com</email>
(R.G.M.);
<email>glynn.webb@students.pcmd.ac.uk</email>
(G.W.);
<email>kathy.woolson@nhs.net</email>
(K.L.W.);
<email>Harry.Dalton@rcht.cornwall.nhs.uk</email>
(H.R.D.)</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Viruses</title>
<idno type="eISSN">1999-4915</idno>
<imprint>
<date when="2016">2016</date>
</imprint>
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<front>
<div type="abstract" xml:lang="en">
<p>There have been large numbers of studies on anti-HEV IgG seroprevalence in Europe, however, the results of these studies have produced high variability of seroprevalence rates, making interpretation increasingly problematic. Therefore, the aim of this study was to develop a clearer understanding of anti-HEV IgG seroprevalence in Europe and identify risk groups for HEV exposure by a meta-analysis of published studies.
<bold>Methods:</bold>
All European HEV-seroprevalence studies from 2003 to 2015 were reviewed. Data were stratified by assay, geographical location, and patient cohort (general population, patients with HIV, solid-organ transplant recipients, chronic liver disease patients, and individuals in contact with swine/wild animals). Data were pooled using a mixed-effects model.
<bold>Results:</bold>
Four hundred thirty-two studies were initially identified, of which 73 studies were included in the analysis. Seroprevalence estimates ranged from 0.6% to 52.5%, increased with age, but were unrelated to gender. General population seroprevalence varied depending on assays: Wantai (WT): 17%, Mikrogen (MG): 10%, MP-diagnostics (MP): 7%, DiaPro: 4%, Abbott 2%. The WT assay reported significantly higher seroprevalence rates across all cohorts (
<italic>p</italic>
< 0.001). Individuals in contact with swine/wild animals had significantly higher seroprevalence rates than the general population, irrespective of assay (
<italic>p</italic>
< 0.0001). There was no difference between any other cohorts. The highest seroprevalence was observed in France (WT: 32%, MP: 16%) the lowest in Italy (WT: 7.5%, MP 0.9%). Seroprevalence varied between and within countries. The observed heterogeneity was attributed to geographical region (23%), assay employed (23%) and study cohort (7%).
<bold>Conclusion</bold>
: Seroprevalcence rates primarily depend on the seroassy that is used, followed by the geographical region and study cohort. Seroprevalence is higher in individuals exposed to swine and/or wild animals, and increases with age.</p>
</div>
</front>
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<name sortKey="Dalton, Harry Richard" sort="Dalton, Harry Richard" uniqKey="Dalton H" first="Harry Richard" last="Dalton">Harry Richard Dalton</name>
<name sortKey="Hartl, Johannes" sort="Hartl, Johannes" uniqKey="Hartl J" first="Johannes" last="Hartl">Johannes Hartl</name>
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<name sortKey="Madden, Richie Guy" sort="Madden, Richie Guy" uniqKey="Madden R" first="Richie Guy" last="Madden">Richie Guy Madden</name>
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<name sortKey="Pischke, Sven" sort="Pischke, Sven" uniqKey="Pischke S" first="Sven" last="Pischke">Sven Pischke</name>
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<name sortKey="Woolson, Kathy Louise" sort="Woolson, Kathy Louise" uniqKey="Woolson K" first="Kathy Louise" last="Woolson">Kathy Louise Woolson</name>
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