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Hepatitis E Virus Seroprevalence and Associated Risk Factors in Pregnant Women Attending Antenatal Consultations in Senegal. Viruses 2022; 14:v14081742. [PMID: 36016364 PMCID: PMC9416362 DOI: 10.3390/v14081742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
In West Africa, research on the hepatitis E virus (HEV) is barely covered, despite the recorded outbreaks. The low level of access to safe water and adequate sanitation is still one of the main factors of HEV spread in developing countries. HEV infection induces acute or sub-clinical liver diseases with a mortality rate ranging from 0.5 to 4%. The mortality rate is more alarming (15 to 25%) among pregnant women, especially in the last trimester of pregnancy. Herein, we conducted a multicentric socio-demographic and seroepidemiological survey of HEV in Senegal among pregnant women. A consecutive and non-redundant recruitment of participants was carried out over the period of 5 months, from March to July 2021. A total of 1227 consenting participants attending antenatal clinics responded to a standard questionnaire. Plasma samples were collected and tested for anti-HEV IgM and IgG by using the WANTAI HEV-IgM and IgG ELISA assay. The overall HEV seroprevalence was 7.8% (n = 96), with 0.5% (n = 6) and 7.4% (n = 91) for HEV IgM and HEV IgG, respectively. One of the participant samples was IgM/IgG-positive, while four were declared indeterminate to anti-HEV IgM as per the manufacturer’s instructions. From one locality to another, the seroprevalence of HEV antibodies varied from 0 to 1% for HEV IgM and from 1.5 to 10.5% for HEV IgG. The data also showed that seroprevalence varied significantly by marital status (p < 0.0001), by the regularity of income (p = 0.0043), and by access to sanitation services (p = 0.0006). These data could serve as a basis to setup national prevention strategies focused on socio-cultural, environmental, and behavioral aspects for a better management of HEV infection in Senegal.
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Shimakawa Y, Njai HF, Takahashi K, Berg L, Ndow G, Jeng-Barry A, Ceesay A, Tamba S, Opoku E, Taal M, Akbar SMF, Arai M, D'Alessandro U, Taylor-Robinson SD, Njie R, Mishiro S, Thursz MR, Lemoine M. Hepatitis E virus infection and acute-on-chronic liver failure in West Africa: a case-control study from The Gambia. Aliment Pharmacol Ther 2016; 43:375-84. [PMID: 26623967 DOI: 10.1111/apt.13484] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/17/2015] [Accepted: 11/04/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND In sub-Saharan Africa, it is unknown whether hepatitis E virus (HEV) infection is a common precipitating event of acute-on-chronic liver failure (ACLF). AIMS To estimate the prevalence of HEV infection in general population and assess whether HEV is a common trigger of ACLF in cirrhotic patients in The Gambia, West Africa. METHODS We first conducted an HEV sero-survey in healthy volunteers. We then tested cirrhotic patients with ACLF (cases) and compensated cirrhosis (controls) for anti-HEV IgG as a marker of exposure to HEV, and anti-HEV IgA and HEV RNA as a marker of recent infection. We also described the characteristics and survival of the ACLF cases and controls. RESULTS In the healthy volunteers (n = 204), 13.7% (95% CI: 9.6-19.2) were positive for anti-HEV IgG, and none had positive HEV viraemia. After adjusting for age and sex, the following were associated with positive anti-HEV IgG: being a Christian, a farmer, drinking water from wells, handling pigs and eating pork. In 40 cases (median age: 45 years, 72.5% male) and 71 controls (39 years, 74.6% male), ≥70% were infected with hepatitis B virus. Although hepatitis B flare and sepsis were important precipitating events of ACLF, none had marker of acute HEV. ACLF cases had high (70.0%) 28-day mortality. CONCLUSIONS Hepatitis E virus infection is endemic in The Gambia, where both faecal-oral route (contaminated water) and zoonotic transmission (pigs/pork meat) may be important. However, acute HEV was not a common cause of acute-on-chronic liver failure in The Gambia.
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Affiliation(s)
- Y Shimakawa
- MRC Unit The Gambia, Banjul, The Gambia.,Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
| | - H F Njai
- MRC Unit The Gambia, Banjul, The Gambia
| | - K Takahashi
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | - L Berg
- MRC Unit The Gambia, Banjul, The Gambia.,Hepatology Unit, Department of Medicine, Imperial College London, London, UK
| | - G Ndow
- MRC Unit The Gambia, Banjul, The Gambia.,Hepatology Unit, Department of Medicine, Imperial College London, London, UK
| | | | - A Ceesay
- MRC Unit The Gambia, Banjul, The Gambia
| | - S Tamba
- MRC Unit The Gambia, Banjul, The Gambia
| | - E Opoku
- MRC Unit The Gambia, Banjul, The Gambia.,Hepatology Unit, Department of Medicine, Imperial College London, London, UK
| | - M Taal
- Ministry of Health and Social Welfare, Banjul, The Gambia
| | - S M F Akbar
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | - M Arai
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | | | - S D Taylor-Robinson
- Hepatology Unit, Department of Medicine, Imperial College London, London, UK
| | - R Njie
- MRC Unit The Gambia, Banjul, The Gambia.,The Gambia Hepatitis Intervention Study, IARC, c/o MRC Unit, Banjul, The Gambia
| | - S Mishiro
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | - M R Thursz
- Hepatology Unit, Department of Medicine, Imperial College London, London, UK
| | - M Lemoine
- MRC Unit The Gambia, Banjul, The Gambia.,Hepatology Unit, Department of Medicine, Imperial College London, London, UK
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The epidemiology of hepatitis C virus in the Maghreb region: systematic review and meta-analyses. PLoS One 2015; 10:e0121873. [PMID: 25803848 PMCID: PMC4372394 DOI: 10.1371/journal.pone.0121873] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 02/07/2015] [Indexed: 02/06/2023] Open
Abstract
Objective To systematically review and synthesize available epidemiological data on hepatitis C virus (HCV) prevalence and incidence in the Maghreb region and to estimate the country-specific population-level HCV prevalence. Methods We conducted a systematic review of HCV antibody prevalence and incidence in the Maghreb countries as outlined by the PRISMA guidelines. Meta-analyses were conducted using DerSimonian-Laird random-effect models with inverse variance weighting to pool HCV prevalence estimates among general population groups. Results We identified 133 HCV prevalence measures and two HCV incidence measures. Among high risk groups, HCV prevalence ranged between 22% and 94% among people who inject drugs, 20% and 76% among dialysis patients, and 2% and 51% among hemophiliacs. Among intermediate-risk groups, considerable but widely variable HCV prevalence was found. Most common risk factors cited across studies were the duration of dialysis, number of transfusions, and having a history of surgery or dental work. The national HCV prevalence in Algeria was estimated at 0.3% (95%CI: 0.1–0.5), Libya 1.2% (95%CI: 1.1–1.3), Mauritania 1.1% (95%CI: 0–2.3), Morocco 0.8% (95%CI: 0.5–1.2), and Tunisia 0.6% (95%CI: 0.5–0.8). Conclusions HCV prevalence in the Maghreb region of the Middle East and North Africa is comparable to that in developed countries of about 1%. HCV exposures appear often to be linked to medical care and are suggestive of ongoing transmission in such settings. Injecting drug use appears also to be a major, though not dominant, contributor to HCV transmission. Further research is needed to draw a more thorough understanding of HCV epidemiology, especially in the countries with limited number of studies. HCV prevention policy and programming in these countries should focus on the settings of exposure.
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Rosenberg DM, Cook SF, Lanza LL. Health care, treatment patterns and cost of services for patients infected with chronic hepatitis C virus in a large insured New England population. J Viral Hepat 2000; 7:361-7. [PMID: 10971824 DOI: 10.1046/j.1365-2893.2000.00232.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The purpose of this study was to describe the cost of health care and the patterns of treatment of young patients (under 65 years of age) identified in health insurance claims as having received services for chronic hepatitis C virus (HCV) infection. We screened computerized claims from a US indemnity and managed care organization for out-patient and in-patient diagnoses related to HCV. Treatment patterns and costs of services were evaluated in the following sites of care: in-patient care, emergency room, hospital out-patient care, ambulatory office care and pharmaceuticals. There were 191 patients with chronic HCV-related claims in this study population (25 per 100 000), during 1995-97. Medical services and pharmaceutical costs in total (US$ 7.1 million) constituted a considerable cost in patients with chronic HCV-related claims during 1995-97. A subset of 98 patients were prescribed interferon-alpha with substantial variability in treatment regimens. Claims data provides a unique opportunity to estimate dollars paid for treatment patterns and health services in a 'real world' insured population and contributes to the understanding of health services for chronic HCV.
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Affiliation(s)
- D M Rosenberg
- Glaxo Wellcome Inc., Research Triangle Park, NC, USA
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Menendez C, Sanchez-Tapias JM, Kahigwa E, Mshinda H, Costa J, Vidal J, Acosta C, Lopez-Labrador X, Olmedo E, Navia M, Tanner M, Rodes J, Alonso PL. Prevalence and mother-to-infant transmission of hepatitis viruses B, C, and E in Southern Tanzania. J Med Virol 1999; 58:215-20. [PMID: 10447415 DOI: 10.1002/(sici)1096-9071(199907)58:3<215::aid-jmv5>3.0.co;2-k] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Hepatitis B and C markers were tested in 980 pregnant women, in the infants born to infected mothers, and in a random sample of 42 and 50, respectively, children born to uninfected mothers in Tanzania. Sixty-two women (6.3%) were positive for HBsAg and 15 (24%) were HBeAg-seropositive. Anti-HCV was detected in 49 women (5%), 15 (31%) of whom had detectable viremia. HCV RNA serum levels were low and only genotype 4 was identified. Sixty-six women (6.7%) were positive for anti-HIV, six of whom were coinfected with HBV and one with HCV. Anti-HEV was negative in the 180 women tested. At 8 months of age, HBsAg was detected in 8% and 2% of children born to HBV-infected and noninfected mothers, respectively (P = 0.2). Corresponding figures at 18 months of age were 31% and 21% (P = 0.3). When tested at 2 months of age, HCV RNA was not detected in any of the 43 children born to anti-HCV-positive mothers nor in any of 50 children born to anti-HCV-negative mothers. At 18 months, only one child, born to an anti-HCV-positive mother, had detectable HCV RNA. None of the infants born to women with HIV coinfection were infected with hepatitis viruses. This study suggests that exposure to HEV does not occur in southern Tanzania. The prevalence of current HBV infection in pregnant women from rural Tanzania is lower than in other sub-Saharan areas. In early childhood, HBV infection appears to occur by horizontal rather than maternofilial mechanisms of transmission. The prevalence of HCV infection is similar to that in other African countries. The results of this study show for the first time in Africa that mother-to-infant transmission does not play a significant role in the acquisition of HCV infection.
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MESH Headings
- Adolescent
- Adult
- Child
- Child, Preschool
- DNA, Viral/blood
- Female
- Follow-Up Studies
- Hepatitis B/epidemiology
- Hepatitis B/prevention & control
- Hepatitis B/transmission
- Hepatitis B Surface Antigens/blood
- Hepatitis B e Antigens/blood
- Hepatitis C/epidemiology
- Hepatitis C/prevention & control
- Hepatitis C/transmission
- Hepatitis E/epidemiology
- Hepatitis E/prevention & control
- Hepatitis E/transmission
- Hepatitis, Viral, Human/epidemiology
- Hepatitis, Viral, Human/prevention & control
- Hepatitis, Viral, Human/transmission
- Humans
- Infant
- Infectious Disease Transmission, Vertical
- Middle Aged
- Pregnancy
- Pregnancy Complications, Infectious/blood
- Pregnancy Complications, Infectious/virology
- Prevalence
- RNA, Viral/blood
- Tanzania/epidemiology
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Affiliation(s)
- C Menendez
- Unidad de Epidemiologia y Bioestadistica, Institut d'Investigacions Biomedicas August Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain.
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