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Vasconcelos MPA, de Oliveira JM, Sánchez-Arcila JC, Faria SC, Rodrigues MM, Perce-da-Silva D, Rezende-Neto J, Pinto MA, Maia-Herzog M, Banic DM, Oliveira-Ferreira J. Seroprevalence of the Hepatitis E Virus in Indigenous and Non-Indigenous Communities from the Brazilian Amazon Basin. Microorganisms 2024; 12:365. [PMID: 38399768 PMCID: PMC10891770 DOI: 10.3390/microorganisms12020365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
Hepatitis E virus (HEV) infection is a common cause of acute viral hepatitis in tropical regions. In Brazil, HEV G3 is the only genotype detected to date. Reports on HEV prevalence are heterogeneous. We aimed to compare the prevalence of anti-HEV among three populations living in the Brazilian Amazon basin. Two cross-sectional studies were conducted in urban, rural, and Yanomami indigenous areas. Plasma samples from 428 indigenous and 383 non-indigenous subjects were tested for anti-HEV IgG using enzyme-linked immunosorbent assays. The overall prevalence of anti-HEV was 6.8% (95%CI: 5.25-8.72), with 2.8% (12/428) found in the Yanomami areas, 3% (3/101) in an urban area, and 14.2% (40/282) in a rural area. Multivariate logistic analysis indicated that patients aged 31-45 years or ≥46 years are more likely to present anti-HEV positivity, with a respective aOR of 2.76 (95%CI: 1.09-7.5) and 4.27 (95%CI: 1.58-12.35). Furthermore, residence in a rural area (aOR: 7.67; 95%CI: 2.50-33.67) represents a relevant risk factor for HEV infection. Additional studies detecting HEV RNA in fecal samples from both humans and potential animal reservoirs are necessary to comprehensively identify risk factors associated with HEV exposure.
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Affiliation(s)
- Mariana Pinheiro Alves Vasconcelos
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz—FIOCRUZ/IOC, Rio de Janeiro 21045-900, Brazil; (M.P.A.V.); (J.C.S.-A.)
- Centro de Medicina Tropical de Rondônia—CEMETRON, Porto Velho 76812-329, Brazil
| | - Jaqueline Mendes de Oliveira
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro 21045-900, Brazil; (J.M.d.O.); (S.C.F.); (M.A.P.)
| | - Juan Camilo Sánchez-Arcila
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz—FIOCRUZ/IOC, Rio de Janeiro 21045-900, Brazil; (M.P.A.V.); (J.C.S.-A.)
| | - Sarah Castro Faria
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro 21045-900, Brazil; (J.M.d.O.); (S.C.F.); (M.A.P.)
| | | | - Daiana Perce-da-Silva
- Laboratório de Imunologia Clínica, Instituto Oswaldo Cruz—FIOCRUZ/IOC, Rio de Janeiro 21045-900, Brazil; (D.P.-d.-S.); (D.M.B.)
| | | | - Marcelo Alves Pinto
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro 21045-900, Brazil; (J.M.d.O.); (S.C.F.); (M.A.P.)
| | - Marilza Maia-Herzog
- Laboratório de Referência Nacional em Simulídeos, Oncocercose e Mansonelose, Coleção de Simulídeos do Instituto Oswaldo Cruz—FIOCRUZ/IOC, Rio de Janeiro 21045-900, Brazil;
| | - Dalma Maria Banic
- Laboratório de Imunologia Clínica, Instituto Oswaldo Cruz—FIOCRUZ/IOC, Rio de Janeiro 21045-900, Brazil; (D.P.-d.-S.); (D.M.B.)
| | - Joseli Oliveira-Ferreira
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz—FIOCRUZ/IOC, Rio de Janeiro 21045-900, Brazil; (M.P.A.V.); (J.C.S.-A.)
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de Oliveira JM, dos Santos DRL, Pinto MA. Hepatitis E Virus Research in Brazil: Looking Back and Forwards. Viruses 2023; 15:548. [PMID: 36851763 PMCID: PMC9965705 DOI: 10.3390/v15020548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/19/2023] Open
Abstract
Hepatitis E virus (HEV) has emerged as a public health concern in Brazil. From the first identification and characterization of porcine and human HEV-3 strains in the 2000s, new HEV subtypes have been identified from animal, human, and environmental isolates. As new potential animal reservoirs have emerged, there is a need to compile evidence on the zoonotic dissemination of the virus in animal hosts and the environment. The increasing amount of seroprevalence data on sampled and randomly selected populations must be systematically retrieved, interpreted, and considered under the One Health concept. This review focused on HEV seroprevalence data in distinct animal reservoirs and human populations reported in the last two decades. Furthermore, the expertise with experimental infection models using non-human primates may provide new insights into HEV pathogenesis, prevention, and environmental surveillance.
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Affiliation(s)
- Jaqueline Mendes de Oliveira
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro 21040-360, Brazil
| | | | - Marcelo Alves Pinto
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro 21040-360, Brazil
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Fernández Villalobos NV, Kessel B, Rodiah I, Ott JJ, Lange B, Krause G. Seroprevalence of hepatitis E virus infection in the Americas: Estimates from a systematic review and meta-analysis. PLoS One 2022; 17:e0269253. [PMID: 35648773 PMCID: PMC9159553 DOI: 10.1371/journal.pone.0269253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Hepatitis E virus (HEV) infection is responsible for inflammatory liver disease and can cause severe health problems. Because the seroprevalence of HEV varies within different population groups and between regions of the continent, we conducted a systematic review on the topic in order to provide evidence for targeted prevention strategies.
Methods
We performed a systematic review in PubMed, SCIELO, LILACS, EBSCO, and Cochrane Library and included reports up to 25 May 2021 (PROSPERO registration number: CRD42020173934). We assessed the risk of bias, publication bias, and heterogeneity between studies and conducted a random-effect meta-analysis for proportions using a (binomial-normal) generalized linear mixed model (GLMM) fitted by Maximum Likelihood (ML). We also reported other characteristics like genotype and risk factors.
Results
Of 1212 identified records, 142 fulfilled the inclusion criteria and were included in the qualitative analysis and 132 in the quantitative analysis. Our random-effects GLMM pooled overall estimate for past infection (IgG) was 7.7% (95% CI 6.4%–9.2%) with high heterogeneity (I2 = 97%). We found higher seroprevalence in certain population groups, for example in people with pig related exposure for IgG (ranges from 6.2%–28% and pooled estimate of 13.8%, 95% CI: 7.6%–23.6%), or with diagnosed or suspected acute viral hepatitis for IgM (ranges from 0.3%–23.9% and pooled estimate of 5.5%, 95% CI: 2.0%–14.1%). Increasing age, contact with pigs and meat products, and low socioeconomic conditions are the main risk factors for HEV infection. Genotype 1 and 3 were documented across the region.
Conclusion
HEV seroprevalence estimates demonstrated high variability within the Americas. There are population groups with higher seroprevalence and reported risk factors for HEV infection that need to be prioritized for further research. Due to human transmission and zoonotic infections in the region, preventive strategies should include water sanitation, occupational health, and food safety.
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Affiliation(s)
| | - Barbora Kessel
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
| | - Isti Rodiah
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
| | - Jördis Jennifer Ott
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
- German Centre for Infection Research (DZIF), Braunschweig, Germany
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
- German Centre for Infection Research (DZIF), Braunschweig, Germany
- Twincore, Centre for Experimental and Clinical Infection Research, Braunschweig-Hannover, Germany
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Moraes DFDSD, Mesquita JR, Dutra V, Nascimento MSJ. Systematic Review of Hepatitis E Virus in Brazil: A One-Health Approach of the Human-Animal-Environment Triad. Animals (Basel) 2021; 11:ani11082290. [PMID: 34438747 PMCID: PMC8388429 DOI: 10.3390/ani11082290] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Hepatitis E virus (HEV) is an important causative agent of acute and chronic hepatitis worldwide. Originally identified in epidemics associated with flooding in Asia, it nowadays shows very distinct genetic and epidemiological patterns. While HEV genotypes (HEV-) 1 and 2 are associated with the original outbreaks (waterborne diseases), HEV-3 and HEV-4 present a zoonotic pattern (associated with consumption of meat from infected animals), HEV-5 and 6 have been found only in wild boar in Japan, and HEV-7 and 8 have been detected in camels and dromedary seldom affecting humans. Brazil, with a precarious sanitary structure and being an important world meat producer, was the focus of this study in order to identify patterns of occurrence of HEV. After reviewing scientific studies, it was identified that the only genotype found in Brazil is HEV-3 and the area where there were more reports was the South region of the country. This is the region that produces more pork. These results indicate that HEV-3 is widespread in the country and sanitary surveillance is essential in the national production of pigs, as well as the implementation of monitoring protocols in hospitals. Abstract Brazil is the fifth largest country in the world with diverse socioeconomic and sanitary conditions, also being the fourth largest pig producer in the world. The aim of the present systematic review was to collect and summarize all HEV published data from Brazil (from 1995 to October 2020) performed in humans, animals, and the environment, in a One Health perspective. A total of 2173 papers were retrieved from five search databases (LILACs, Mendeley, PubMed, Scopus, and Web of Science) resulting in 71 eligible papers after application of exclusion/inclusion criteria. Data shows that HEV genotype 3 (HEV-3) was the only retrieved genotype in humans, animals, and environment in Brazil. The South region showed the highest human seroprevalence and also the highest pig density and industry, suggesting a zoonotic link. HEV-1 and 2 were not detected in Brazil, despite the low sanitary conditions of some regions. From the present review we infer that HEV epidemiology in Brazil is similar to that of industrialized countries (only HEV-3, swine reservoirs, no waterborne transmission, no association with low sanitary conditions). Hence, we alert for the implementation of HEV surveillance systems in swine and for the consideration of HEV in the diagnostic routine of acute and chronic hepatitis in humans.
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Affiliation(s)
- Danny Franciele da Silva Dias Moraes
- Faculty of Veterinary Medicine, Federal University of Mato Grosso, Cuiabá 78060-900, Brazil; (D.F.d.S.D.M.); (V.D.)
- Secretaria de Estado do Meio Ambiente de Mato Grosso (SEMA), Cuiabá 78050-970, Brazil
- Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, 4050-313 Porto, Portugal
| | - João R. Mesquita
- Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, 4050-313 Porto, Portugal
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
- Correspondence:
| | - Valéria Dutra
- Faculty of Veterinary Medicine, Federal University of Mato Grosso, Cuiabá 78060-900, Brazil; (D.F.d.S.D.M.); (V.D.)
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Remondegui C, Ceballos S, Arce LP, Pintado E, Vidaurre R, Nitschko H, Osterman A, Vizoso Pinto MG. Serologic evidence of the circulation of the hepatitis E virus and the prevalence of antibodies against hepatitis A in an indigenous population in northern Argentina. Rev Argent Microbiol 2021; 53:314-324. [PMID: 33648797 DOI: 10.1016/j.ram.2020.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/31/2020] [Accepted: 10/02/2020] [Indexed: 11/29/2022] Open
Abstract
In 2005 a universal vaccination program against hepatitis A was introduced in Argentina. Nevertheless, there are still some unvaccinated marginal population groups. There are no data about the seroprevalence of hepatitis E in the northern region of Argentina mainly because of lack of awareness of this emergent pathogen. We aimed to determine the seroprevalence of hepatitis A, and hepatitis E in an indigenous population in northern Argentina. One hundred and twenty six (126) donor serum samples collected near San Salvador de Jujuy were analyzed for anti-HAV IgG and HEV IgG and IgM, alkaline phosphatase and transaminase values. Volunteers were interviewed about their living conditions, animal farming, consumption of tap water or river water, and level of education. Seroprevalence of specific anti-HAV antibodies was high (80.2%, 95% confidence interval, 72.1-86.7%) in children under 5 years of age, indicating early infection in life. Seroprevalence of anti-HEV antibodies was 5.6% (95% CI: 2.3-11.2%), being slightly higher than the values found in healthy patients from other regions of the country. Although we could not characterize the genotype of the circulating HEV strain, the clear epidemiological difference between seroprevalence of HAV and HEV in a community with poor sanitary conditions suggest that the circulating HEV strains spread through a different transmission route than HAV. Furthermore a significant correlation between anti-HEV IgG and swine farming was found (p<0.05), which supports a zoonotic transmission path. We reassessed the epidemiological pattern of HAV infection and reported evidence of HEV infection for the first-time in a community belonging to the Guarani ethnic group, highlighting the need to include hepatitis E testing in routine diagnostics in the region.
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Affiliation(s)
| | | | - Lorena Paola Arce
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, San Miguel de Tucumán, Argentina; Laboratorio de Ciencias Básicas, OR. Genética, Facultad de Medicina, INSIBIO (CONICET-UNT), Universidad Nacional de Tucumán, Argentina
| | | | - Rene Vidaurre
- Hospital Paterson de San Pedro de Jujuy, Jujuy, Argentina
| | - Hans Nitschko
- Max von Pettenkofer Institute, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Munich, Germany; German Center for Infection Research (DZIF), Partner Site Munich, Germany
| | - Andreas Osterman
- Max von Pettenkofer Institute, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Munich, Germany; German Center for Infection Research (DZIF), Partner Site Munich, Germany
| | - María Guadalupe Vizoso Pinto
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, San Miguel de Tucumán, Argentina; Laboratorio de Ciencias Básicas, OR. Genética, Facultad de Medicina, INSIBIO (CONICET-UNT), Universidad Nacional de Tucumán, Argentina.
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Low prevalence of anti-hepatitis E virus IgG antibodies in Tepehuanos in Mexico. Ann Hepatol 2021; 19:186-189. [PMID: 31771821 DOI: 10.1016/j.aohep.2019.08.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/19/2019] [Accepted: 08/26/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION AND OBJECTIVE The epidemiology of infection with hepatitis E virus (HEV) in Tepehuanos (a Mexican ethnic group living in rural areas) is largely unknown. This study aimed to determine the seroprevalence of and risk factors associated with HEV infection in Tepehuanos in Durango, Mexico, and to compare this seroprevalence with that in non-Tepehuanos. MATERIALS AND METHODS Through a case-control seroprevalence study, we studied 146 Tepehuanos and 146 age- and gender-matched control subjects of the general population from rural settings. The frequency of anti-HEV IgG antibodies was determined using an enzyme-linked immunoassay. Bivariate and multivariate analyses were used to assess the association between seropositivity and socio-demographic, clinical and behavioral characteristics of the Tepehuanos. RESULTS IgG antibodies against HEV were found in 5 (3.4%; 95% CI: 1.1-7.8) of 146 Tepehuanos and in 46 (31.5%; 95% CI: 24.1-39.7) of 146 control subjects (OR=0.01; 95% CI: 0.0007-0.20; P<0.000001). Bivariate analysis showed that HEV seropositivity was associated with age, consumption of meat from goat, sheep, boar, turkey and pigeon, and concrete flooring at home. However, these variables were no longer significant when analyzed by logistic regression. CONCLUSIONS This is first study on the epidemiology of HEV exposure in Tepehuanos. We demonstrated serological evidence of HEV infection in this ethnic group. The seroprevalence of HEV exposure in Tepehuanos is low as compared with that found in non-Tepehuano people living in rural Durango. Further studies to determine the risk factors associated with HEV exposure in Tepehuanos are needed.
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Fernandes J, Oliveira RCD, Coelho TA, Martins RMB, Caetano KAA, Horta MAP, Levis S, Carneiro MADS, Teles SA, Lemos ERSD. Rodent-borne viruses survey in rural settlers from Central Brazil. Mem Inst Oswaldo Cruz 2018; 114:e180448. [PMID: 30569944 PMCID: PMC6319326 DOI: 10.1590/0074-02760180448] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 11/27/2018] [Indexed: 01/14/2023] Open
Abstract
Anthropogenic environmental changes arising from settlement and agriculture include deforestation and replacement of natural vegetation by crops providing opportunities for pathogen spillover from animals to humans. This study aimed to investigate the prevalence of rodent-borne virus infections in seven rural settlements from Midwestern Brazil. Of the 466 individuals tested 12 (2.57%) were reactive for orthohantavirus and 3 (0.64%) for mammarenavirus. These rural settlers lived under unfavorable infrastructure, socioeconomic disadvantages, and unsanitary conditions, representing a risk for rodent-borne infections. Development of public policies towards the improvement of health, sanitation and awareness of rodent-borne diseases in improvised camps and settlements is imperative, in order to reduce morbidity and mortality caused by these diseases.
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Affiliation(s)
- Jorlan Fernandes
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Hantaviroses e Rickettsioses, Rio de Janeiro, RJ, Brasil
| | - Renata Carvalho de Oliveira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Hantaviroses e Rickettsioses, Rio de Janeiro, RJ, Brasil
| | - Thayssa Alves Coelho
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Hantaviroses e Rickettsioses, Rio de Janeiro, RJ, Brasil
| | | | | | | | - Silvana Levis
- Instituto Nacional de Enfermedades Virales Humanas, Pergamino, Argentina
| | | | - Sheila A Teles
- Universidade Federal de Goiás, Faculdade de Enfermagem, Goiânia, GO, Brasil
| | - Elba Regina Sampaio de Lemos
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Hantaviroses e Rickettsioses, Rio de Janeiro, RJ, Brasil
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