Seroprevalence and risk factors of hepatitis E virus infection among children in China.

Hepatitis E virus (HEV) infection is an important public health concern worldwide, especially in developing countries, causing waterborne outbreaks as well as sporadic autochthonous hepatitis. China is usually considered to be a HEV-endemic area, but the prevalence of HEV infection in children in mainland China remains unclear. Between May 2013 and July 2014, a cross-sectional study was conducted to estimate the seroprevalence and potential risk factors associated with the acquisition of HEV infection by children in China. A total of 1,500 healthy children (range 1-18; 942 and 558 from urban and rural areas, respectively) were recruited to examine for the presence of anti-HEV IgG and IgM antibodies by enzyme-linked immunosorbent assay. Socio-demographic and behavioral characteristics from the examined children were obtained. The overall seroprevalence of HEV in the examined children was 14.93%. Of these, 174 (11.60%) were positive for only anti-HEV IgG antibodies, 50 (3.33%) were IgM positive and IgG negative, and 44 (2.93%) were positive for both anti-HEV IgG and IgM antibodies. Age, type of residence area, contact with pigs, and source of drinking water were found to be associated with HEV infection. These findings demonstrated the high prevalence of HEV and the considerable potential for the transmission of HEV infection in children in China.