Tropical Gastroenterology and Nutrition Group, UNZA School of Medicine, Lusaka, Zambia.
J Infect Dis. 2014 Mar 1;209(5):652-7. doi: 10.1093/infdis/jit409. Epub 2013 Aug 6.
Hepatitis E virus (HEV) infection causes major epidemics of infectious hepatitis, with high mortality rates in pregnant women. Recent reports indicate that HEV coinfections with human immunodeficiency virus (HIV) may have a more protracted course. However, the impact of HEV infections in communities heavily affected by HIV remains poorly studied. We set out to examine age-related seroprevalence in a community where we have previously carried out studies on environmental enteropathy.
Blood samples from 194 children and 106 adults were examined for immunoglobulin G and immunoglobulin M antibodies for HEV. HEV data were correlated with HIV status and morphometric analysis of small intestinal biopsies.
Seroprevalence rose throughout childhood, from 8% in children aged 1-4 years, to 36% in children aged 10-14 years. In adults, the overall prevalence was 42%, with 28% in HIV-seronegative adults and 71% in HIV-seropositive adults (odds ratio, 6.2; 95% confidence interval, 2.2-18; P = .0001). In adults, villous height and crypt depth measurements showed that HEV seropositivity was associated with worse enteropathy (P = .05 and P = .005, respectively).
HEV infection is common in Zambia. In adults it is strongly associated with HIV status, and also with environmental enteropathy.
戊型肝炎病毒（HEV）感染可引起重大的传染性肝炎流行，孕妇死亡率较高。最近的报告表明，HEV 与人类免疫缺陷病毒（HIV）的合并感染可能具有更长的病程。然而，在 HIV 感染严重的社区中，HEV 感染的影响仍研究不足。我们着手研究在一个我们之前进行过环境肠病研究的社区中，与年龄相关的血清流行率。
对 194 名儿童和 106 名成人的血液样本进行了戊型肝炎病毒 IgG 和 IgM 抗体检测。HEV 数据与 HIV 状况和小肠活检的形态计量分析相关联。
血清流行率在整个儿童期呈上升趋势，从 1-4 岁儿童的 8%上升到 10-14 岁儿童的 36%。在成年人中，总流行率为 42%，HIV 阴性成年人为 28%，HIV 阳性成年人为 71%（优势比，6.2；95%置信区间，2.2-18；P =.0001）。在成年人中，绒毛高度和隐窝深度的测量表明，HEV 血清阳性与更严重的肠病有关（P =.05 和 P =.005，分别）。
在赞比亚，HEV 感染很常见。在成年人中，它与 HIV 状况密切相关，也与环境肠病有关。
