Hepatitis E seroprevalence in the United States: Results for immunoglobulins IGG and IGM. Issue 1 (9th October 2018)

• Record Type: Journal Article
• Authors: Cangin, Causenge; Focht, Brian; Harris, Randall; Strunk, Julie A.
• Is Part Of: Journal of medical virology. Volume 91:Issue 1(2019)
• Page Start: 124
• Page End: 131
• Publication Date: 2018-10-09
• Subjects: epidemiology -- hepatitis E virus (HEV) -- immunoglobulin; Virology -- Periodicals; 616
• DOI: 10.1002/jmv.25299
• Languages: English
• ISSNs: 0146-6615

Abstract

Abstract : Background: Previous research identified a decline in hepatitis E virus (HEV) seroprevalence in US in 1988‐1994 and 2009‐2010. We investigated most recent HEV epidemiology. Method: Using a nationally representative sample (7656 persons in the National Health and Nutrition Examination Survey [NHANES] 2013‐2014 and 7124 persons in NHANES 2015‐2016), we compared the weighted seroprevalence of HEV (immunoglobulin G [IgG]/immunoglobulin M [IgM]) among people from the US (aged ≧ 6 years) between these two time periods. Sampling‐weighted multivariate logistic regression models were used to identify factors associated with HEV seropositivity. Results: The median participant age was 37 years (interquartile range = 17‐58 years); 51.17% of them were female. Among US‐born individuals, HEV seropositivity (IgG/IgM) increased from 4.5% (95% confidence interval [CI] = 3.5%‐5.5%) in 2013‐2014 to 8.1% (95%CI = 6.5%‐9.7%) in 2015‐2016. Recent HEV infection (IgM) has nearly doubled in all US‐born people. For participants born in and outside of the US, the overall weighted HEV (IgG/IgM) seropositivity increased from 5% (95%CI = 3.9%‐6.1%) during 2013‐2014 to 7.7% (95%CI = 7.2%‐10.5%) during 2015‐2016. In "non‐Hispanic Asian" females, HEV seropositivity (IgG/IgM) rose from 8.4% (95%CI = 5.6%‐11.1%) during 2013‐2014 to 20.7% (95%CI = 15.8%‐25.7%) during 2015‐2016. In "non‐Hispanic Asian" males, HEV seropositivity (IgG/IgM) increased from 9.3% (95%CI = 6.9%‐11.8%) during 2013‐2014 to 16.8% (95%CI = 12.5%‐21.2%) during 2015‐2016. HEV (IgG/IgM) seropositivity was significantly associated with "non‐Hispanic Asian" ethnicity (odds ratio [OR] = 1.69; CI = 1.12‐2.56), female (OR = 1.2, CI = 1.06‐1.38), and age (OR = 1.058, CI = 1.05‐1.06). No clear etiologic agent was found. Conclusion: The combined and strata‐specific HEV weighted seroprevalence increased from 2013‐2014 to 2015‐2016. Although prior studies had found increasing age as the only significant factor associated with HEV, the attribute of "non‐Hispanic Asian" had a stronger association with HEV seropositivity than the age factor alone.