Declining prevalence of hepatitis A and silent circulation of hepatitis E virus infection in southeastern Brazil

Int J Infect Dis. 2020 Dec:101:17-23. doi: 10.1016/j.ijid.2020.09.024. Epub 2020 Sep 16.

Abstract

Objectives: Hepatitis A virus (HAV) infection is considered highly endemic in Brazil, especially in low-income areas. In contrast, only a few human cases of hepatitis E have been reported. This study aimed to estimate the prevalence and potential risk factors of HAV and hepatitis E virus (HEV) infections in an adult population from a rural township of southeastern Brazil.

Methods: We conducted a cross-sectional survey using serum samples from urban and rural residents of Cássia dos Coqueiros, São Paulo state. A total of 990 samples were tested for anti-HAV IgG by chemiluminescent microparticle immunoassay, and a subset of 248 samples tested for anti-HEV IgG, using two commercial ELISA. Variables associated with anti-HAV and anti-HEV positivity were assessed by a multivariate analysis using a binomial logistic regression model.

Results: Seroprevalence of HAV and HEV was 89.1% and 20.7%, respectively. Age was significantly associated with HAV infection. Wantai and Mikrogen ELISA yielded comparable HEV seroprevalence results.

Conclusions: Anti-HAV seroprevalence has declined and correlates with age, whereas anti-HEV was significantly higher than that found in previous population-based studies. These results indicate a need for further investigations of the magnitude of HEV infection in Brazil using the currently available, more sensitive diagnostic methods.

Keywords: Epidemiology; HEV IgG ELISA; Hepatitis A; Hepatitis E; Seroprevalence.

MeSH terms

  • Adolescent
  • Adult
  • Brazil / epidemiology
  • Cross-Sectional Studies
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Hepatitis A / epidemiology*
  • Hepatitis A virus / immunology
  • Hepatitis Antibodies / blood
  • Hepatitis E / epidemiology*
  • Hepatitis E virus / immunology
  • Humans
  • Male
  • Middle Aged
  • Models, Statistical
  • Prevalence
  • Risk Factors
  • Rural Population
  • Seroepidemiologic Studies
  • Young Adult

Substances

  • Hepatitis Antibodies