Department of Microbiology, Faculty of Medicine, Mahidol University, Siriraj Hospital, Bangkok, Thailand.
Department of Internal Medicine, Faculty of Medicine, Mahidol University, Siriraj Hospital, Bangkok, Thailand.
Viral Immunol. 2019 Sep;32(7):302-307. doi: 10.1089/vim.2018.0146. Epub 2019 Aug 12.
Hepatitis E virus (HEV) is a common cause of acute hepatitis infections. Our previous 3-year study at two large Thai hospitals established an occurrence of 4-5% of HEV infections from swine HEV genotype 3 in suspected acute hepatitis patients, with the high incidence in older adults. This study was a serosurvey to determine the prevalence of HEV infections among Thai adults. We obtained sera from 630 healthy blood donors with a median age of 38 (18-64) years who attended Thai Red Cross transfusion units throughout Thailand. The donors were domiciled in 16 provinces in the northern ( = 159), central ( = 193), northeastern ( = 158), and southern ( = 120) regions. The seroprevalence of IgG antibody to HEV (anti-HEV) was determined by the EUROIMMUN test kit, using indirect enzyme-linked immunosorbent assay (ELISA) based on recombinant antigens derived from ORF2 of HEV genotypes 1 and 3. Demographic data, including information related to HEV infection risk (the number of pigs and the proportion of Muslims in each province), were also obtained. The overall anti-HEV prevalence among Thai adults was 29.7%. The frequencies of anti-HEV found in the northern (28.9%, 95% confidence interval [CI] = 22.4-36.4), northeastern (34.8%, 95% CI = 27.8-42.5), and central (35.8%, 95% CI = 29.3-42.7) regions were similar, whereas the frequency in the southern (14.2%, 95% CI = 9.0-21.5) region, known to have a large Muslim population, was low. An increasing frequency of the specific antibody was observed among the elderly. A low HEV infection rate was associated with an Islamic population where there are low number of pigs and low swine consumption. Furthermore, the higher anti-HEV incidences in the northeastern provinces might relate to the local cultural practice of consuming undercooked pork. Besides the need for an HEV vaccination in the future, there is a requirement for rapid early diagnosis; the undertaking of prevention-management campaigns might also reduce the number of infected patients.
戊型肝炎病毒 (HEV) 是急性肝炎感染的常见病因。我们之前在泰国的两家大医院进行了为期 3 年的研究，发现疑似急性肝炎患者中猪源 HEV 基因型 3 引起的 HEV 感染发生率为 4-5%，且在老年人中发病率较高。本研究旨在通过血清学调查确定泰国成年人中 HEV 感染的流行率。我们从泰国红十字会输血单位的 630 名健康献血者中获得了血清，这些献血者的中位年龄为 38（18-64）岁，来自泰国北部（ = 159）、中部（ = 193）、东北部（ = 158）和南部（ = 120）的 16 个省。使用基于 HEV 基因型 1 和 3 的 ORF2 重组抗原的间接酶联免疫吸附试验（ELISA），通过 EUROIMMUN 试剂盒测定抗 HEV（抗-HEV）IgG 抗体的血清阳性率。还获得了人口统计学数据，包括与 HEV 感染风险相关的信息（每个省的猪数量和穆斯林比例）。泰国成年人的总抗-HEV 流行率为 29.7%。北部（28.9%，95%置信区间 [CI] = 22.4-36.4）、东北部（34.8%，95% CI = 27.8-42.5）和中部（35.8%，95% CI = 29.3-42.7）地区的抗-HEV 检出率相似，而南部（14.2%，95% CI = 9.0-21.5）地区的检出率较低，该地区穆斯林人口众多。随着年龄的增长，特定抗体的频率也有所增加。HEV 感染率较低与伊斯兰教人口相关，这些地区猪的数量较少，猪肉消费量也较低。此外，东北部省份较高的抗-HEV 发生率可能与当地食用未煮熟猪肉的文化习俗有关。除了未来需要进行 HEV 疫苗接种外，还需要快速进行早期诊断；开展预防管理活动也可能会减少感染患者的数量。
