National Health Laboratory Service, Groote Schuur Hospital, Cape Town, and Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, South Africa.
S Afr Med J. 2019 Jul 26;109(8):582-583. doi: 10.7196/SAMJ.2019.v109i8.13867.
Early hepatitis E virus (HEV) seroprevalence studies in South Africa (SA) showed seroprevalence rates of 2 - 10%, and suggested waterborne transmission. More recent studies in Cape Town, SA, reported HEV seroprevalence rates of 28% and 26% in outpatients without liver disease and blood donors, respectively. An association was found with eating pork or bacon/ham. Only 3 human cases of hepatitis E in SA have been reported in the literature.
To find evidence of HEV infection in hospitalised patients with acute hepatitis and no other identified cause.
Leftover serum samples were retrieved for patients negative for hepatitis viruses A, B and C, where no other cause of hepatitis was identified. Samples were tested for HEV by polymerase chain reaction (PCR) and IgM and IgG enzyme-linked immunosorbent assay (ELISA).
Anti-HEV IgG was detected in 39/132 specimens (29.5%; 95% confidence interval (CI) 22.4 - 37.8), and anti-HEV IgM in 2/125 specimens (1.6%; 95% CI 0.4 - 5.7). No specimen tested positive by PCR.
IgG seroprevalence found in this study was similar to that previously reported in Cape Town. IgM positivity in 2 patients was not confirmed by PCR. Locally, hepatitis E may not be a common cause of clinically apparent hepatitis that requires hospitalisation.
南非（SA）的早期戊型肝炎病毒（HEV）血清流行率研究显示血清流行率为 2-10%，提示为水传播。最近在开普敦，SA 的研究报告称，无肝病的门诊患者和献血者的 HEV 血清流行率分别为 28%和 26%。发现与食用猪肉或培根/火腿有关。文献中仅报告了南非 3 例人类戊型肝炎病例。
在没有其他明确病因的急性肝炎住院患者中寻找 HEV 感染的证据。
对甲型、乙型和丙型肝炎病毒阴性且未发现其他肝炎病因的患者，检索剩余血清样本。采用聚合酶链反应（PCR）和酶联免疫吸附试验（ELISA）检测 HEV 的 IgM 和 IgG。
在 132 份标本中有 39 份（29.5%；95%置信区间[CI]22.4-37.8）检测到抗-HEV IgG，在 125 份标本中有 2 份（1.6%；95%CI0.4-5.7）检测到抗-HEV IgM。没有标本通过 PCR 检测呈阳性。
本研究中 IgG 的血清流行率与之前在开普敦报道的相似。2 例患者的 IgM 阳性未通过 PCR 确认。在当地，戊型肝炎可能不是需要住院的临床明显肝炎的常见病因。
