Gérardin Patrick, Porphyre Vincent, Tsatoromila Anita, Cuissard Laurent, Becquart Jean-Philippe, Boussaid Karim, Bertolotti Antoine, Naze Florence, Picot Sandrine, Filleul Laurent, Tortosa Pablo, Jaubert Julien, Guernier Vanina, Pascalis Hervé
INSERM Centre d'Investigation Clinique 1410 Epidémiologie Clinique, Centre Hospitalier Universitaire (CHU), Réunion, Saint Pierre, Reunion.
UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical. Université de La Réunion, INSERM 1187, CNRS 9192, IRD 249, CYROI, Sainte Clotilde, Reunion.
One Health. 2019 Oct 23;8:100110. doi: 10.1016/j.onehlt.2019.100110. eCollection 2019 Dec.
Hepatitis E virus (HEV) has been scarcely investigated in the Indian Ocean. Following a nationwide serosurvey among blood donors, we conducted a population-based serosurvey to assess the magnitude of HEV exposure on Reunion Island.
Four hundred and sixty-six archived frozen human sera from the 2009 CoPanFlu-RUN cohort were analysed using the Wantai HEV IgG enzyme immunoassay. HEV seropositivity was defined as an IgG titre ≥5 UI/ml. Raw and weighted seroprevalences were assessed to account for the discrepancy between the CoPanFlu-RUN subset and the general community. Prevalence proportion ratios (PPR) were measured using log-binomial models.
The raw and the weighted seroprevalences of HEV were 9.01% (95% CI 6.41-11.61) and 6.73% (95% CI 4.47-8.98), respectively. The presence of HEV IgG antibodies was associated with increasing age ( < 0.001). In a survey-adjusted model minimizing the sampling bias and adjusting for age, males were more likely to be seropositive than females (adjusted PPR 2.59, 95% CI 1.07-6.25). Seropositivity was spatially heterogeneous across the island ( < 0.01). Living in the neighbourhood of a pig farm within a low to intermediate slope area was associated with seropositivity in several models adjusting for age, gender, altitude of residency and interaction between slope and pig farms.
Reunion Island is a low endemic area for HEV exposure. Despite limitations related to the retrospective study design, our findings confirm the roles of cumulative lifetime exposure and male gender in HEV exposure. The risk associated with neighbouring pig farms might also suggest environmental contamination in this setting.
在印度洋地区，戊型肝炎病毒（HEV）的研究极少。在对献血者进行全国性血清学调查之后，我们开展了一项基于人群的血清学调查，以评估留尼汪岛戊型肝炎病毒暴露的程度。
使用万泰戊型肝炎病毒IgG酶免疫分析法，对2009年CoPanFlu-RUN队列中的466份存档冷冻人血清进行分析。戊型肝炎病毒血清阳性定义为IgG滴度≥5 UI/ml。评估原始血清阳性率和加权血清阳性率，以考虑CoPanFlu-RUN子集与普通人群之间的差异。使用对数二项模型测量患病率比例比（PPR）。
戊型肝炎病毒的原始血清阳性率和加权血清阳性率分别为9.01%（95%置信区间6.41-11.61）和6.73%（95%置信区间4.47-8.98）。戊型肝炎病毒IgG抗体的存在与年龄增长相关（P<0.001）。在一个最小化抽样偏差并对年龄进行调整的调查校正模型中，男性血清阳性的可能性高于女性（校正PPR 2.59，95%置信区间1.07-6.25）。全岛血清阳性在空间上存在异质性（P<0.01）。在几个对年龄、性别、居住海拔以及坡度与养猪场之间的相互作用进行调整的模型中，生活在低至中等坡度地区的养猪场附近与血清阳性相关。
留尼汪岛是戊型肝炎病毒暴露的低流行地区。尽管本回顾性研究设计存在局限性，但我们的研究结果证实了终生累积暴露和男性性别在戊型肝炎病毒暴露中的作用。与邻近养猪场相关的风险也可能表明在这种情况下存在环境污染。
