Christensen Peer B, Engle Ronald E, Jacobsen Svend Erik H, Krarup Henrik B, Georgsen Jørgen, Purcell Robert H
Department of Clinical Immunology, Odense University Hospital, Odense, Denmark.
J Med Virol. 2002 Jan;66(1):49-55. doi: 10.1002/jmv.2110.
Injecting drug users and prisoners have high prevalences of antibodies to hepatitis A-C. The aim of this study was to determine the prevalence of antibodies to hepatitis E virus (anti-HEV) in two Danish high-risk populations and correlate anti-HEV with risk factors for transmission. Three hundred thirty male prisoners and 137 patients at a drug treatment center were tested for anti-HEV with an in-house enzyme-linked immunoassay (EIA) utilizing antigens derived from open reading frame 2 (ORF2). This was compared with a commercial test with antigens derived from ORF2 and ORF3 (Abbott HEV EIA). In addition the samples were tested for antibodies against hepatitis A-C viruses, human immunodeficiency virus (HIV) 1 and 2, human T lymphotropic virus (HTLV) I and II and herpes simplex virus type 2 (HSV2). The participants were interviewed about risk factors for transmission. The anti-HEV prevalence was 16.9% (95% CI 14-21) for the in-house assay compared to 4.1% (95% CI 2.5-6.3) with the commercial assay. The correlation between the two assays was low (87% overall agreement; kappa value 0.32). One sample was strongly anti-HEV IgM positive, suggesting recent HEV infection inside Denmark. The presence of anti-HEV was associated significantly with anti-HAV among prisoners and increased with age in both groups. In contrast, associations were not found with injecting drug use or sexual risk factors. With the commercial assay an increased prevalence of anti-HEV was found among participants who had spent more than 5 years outside Northern Europe. In conclusion, anti-HEV was highly prevalent among Danish prisoners and drug users but not related to risk factors for blood-borne or sexual transmission.
注射吸毒者和囚犯中甲型至丙型肝炎抗体的流行率很高。本研究的目的是确定丹麦两个高危人群中戊型肝炎病毒抗体（抗-HEV）的流行率，并将抗-HEV与传播风险因素相关联。利用来自开放阅读框2（ORF2）的抗原，采用内部酶联免疫吸附测定（EIA）对330名男性囚犯和一家戒毒中心的137名患者进行了抗-HEV检测。将其与使用来自ORF2和ORF3的抗原的商业检测（雅培戊型肝炎病毒EIA）进行比较。此外，还对样本进行了甲型至丙型肝炎病毒、人类免疫缺陷病毒（HIV）1型和2型、人类嗜T淋巴细胞病毒（HTLV）Ⅰ型和Ⅱ型以及2型单纯疱疹病毒（HSV2）抗体检测。就传播风险因素对参与者进行了访谈。内部检测的抗-HEV流行率为16.9%（95%可信区间14-21），而商业检测的流行率为4.1%（95%可信区间2.5-6.3）。两种检测方法之间的相关性较低（总体一致性为87%；kappa值为0.32）。有一个样本抗-HEV IgM呈强阳性，提示在丹麦境内近期有戊型肝炎病毒感染。囚犯中抗-HEV的存在与抗-HAV显著相关，且在两组中均随年龄增加而升高。相比之下，未发现与注射吸毒或性传播风险因素有关。采用商业检测方法发现，在北欧以外地区度过5年以上的参与者中抗-HEV流行率升高。总之，抗-HEV在丹麦囚犯和吸毒者中高度流行，但与血源性或性传播风险因素无关。
