Haider N, Khan M S U, Hossain M B, Sazzad H M S, Rahman M Z, Ahmed F, Zeidner N S
International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh.
American International University-Bangladesh, Dhaka, Bangladesh.
Zoonoses Public Health. 2017 Nov;64(7):572-577. doi: 10.1111/zph.12372. Epub 2017 Jul 2.
Hepatitis E virus (HEV) is the most common cause of viral hepatitis in humans. Pigs may act as a reservoir of HEV, and pig handlers were frequently identified with a higher prevalence of antibodies to HEV. The objectives of this study were to identify evidence of HEV infection in pigs and compare the history of jaundice between pig handlers and people not exposed to pigs and pork. Blood and faecal samples were collected from 100 pigs derived from three slaughterhouses in the Gazipur district of Bangladesh from January to June, 2011. We also interviewed 200 pig handlers and 250 non-exposed people who did not eat pork or handled pigs in the past 2 years. We tested the pig sera for HEV-specific antibodies using a competitive ELISA and pig faecal samples for HEV RNA using real-time RT-PCR. Of 100 pig sera, 82% (n = 82) had detectable antibody against HEV. Of the 200 pig handlers, 28% (56/200) demonstrated jaundice within the past 2 years, whereas only 17% (43/250) of controls had a history of jaundice (p < .05). Compared to non-exposed people, those who slaughtered pigs (31% versus 15%, p < .001), reared pigs (37% versus 20%, p < .001), butchered pigs (35% versus 19%, p < .001) or involved in pork transportation (28% versus 13%, p < .001) were more likely to be affected with jaundice in the preceding 2 years. In multivariate logistic regression analysis, exposure to pigs (odds ratio [OR]: 2.2, 95% CI: 1.2-3.9) and age (OR: 0.97, 95% CI: 0.95-0.99) was significantly associated with jaundice in the past 2 years. Pigs in Bangladesh demonstrated evidence of HEV infection, and a history of jaundice was significantly more frequent in pig handlers. Identifying and genotyping HEV in pigs and pig handlers may provide further evidence of the pig's role in zoonotic HEV transmission in Bangladesh.
戊型肝炎病毒（HEV）是人类病毒性肝炎最常见的病因。猪可能是HEV的储存宿主，养猪人员中戊型肝炎病毒抗体的患病率通常较高。本研究的目的是确定猪感染HEV的证据，并比较养猪人员与未接触猪和猪肉的人员的黄疸病史。2011年1月至6月，从孟加拉国加济布尔区三个屠宰场的100头猪采集血液和粪便样本。我们还采访了200名养猪人员和250名在过去两年中未食用猪肉或接触猪的未接触者。我们使用竞争性ELISA检测猪血清中的HEV特异性抗体，使用实时RT-PCR检测猪粪便样本中的HEV RNA。在100份猪血清中，82%（n = 82）可检测到抗HEV抗体。在200名养猪人员中，28%（56/200）在过去两年内出现黄疸，而对照组中只有17%（43/250）有黄疸病史（p < 0.05）。与未接触者相比，在过去两年内，屠宰猪的人员（31%对15%，p < 0.001）、饲养猪的人员（37%对20%，p < 0.001）、屠宰猪的人员（35%对19%，p < 0.001）或参与猪肉运输的人员（28%对13%，p < 0.001）患黄疸的可能性更高。在多因素逻辑回归分析中，接触猪（比值比[OR]：2.2，95%置信区间：1.2 - 3.9）和年龄（OR：0.97，95%置信区间：0.95 - 0.99）与过去两年内的黄疸显著相关。孟加拉国的猪显示出感染HEV的证据，养猪人员黄疸病史的发生率明显更高。对猪和养猪人员中的HEV进行鉴定和基因分型，可能为猪在孟加拉国人畜共患HEV传播中的作用提供进一步证据。
