Unveiling the Hepatitis E Seroprevalence: Insights from Dicle University Hospital in Southeastern Turkey

Year 2024, Volume: 50 Issue: 1, 64 - 71, 14.03.2024

Nida Özcan Serkan Kaydas Ahmet Kazar Hakan Temiz

https://doi.org/10.5798/dicletip.1451584

Abstract

Introduction: Hepatitis E virus (HEV) is a substantial concern for public health with varying seroprevalence rates globally. In this study, HEV seroprevalence in patients admitted to Dicle University Hospital, in the southeastern area of Turkey, was investigated.
Methods: The test results for immunoglobulin M type HEV antibodies (Anti-HEV IgM) and immunoglobulin G type HEV antibodies (Anti-HEV IgG) of patients applied to Dicle University Hospital for various reasons between 2017 and 2021 were retrospectively analyzed. The sera samples underwent testing to identify IgG and IgM antibodies using HEV IgG and HEV IgM test kits (Dia-Pro Diagnostic Bioprobes, Milan, Italy) on the Triturus micro-ELISA system (Grifols SA, Barcelona, Spain). The study included both adult and pediatric patients. Statistical analysis was conducted to assess the associations between gender and age groups (pediatric and adult) and HEV seropositivity utilizing the chi-square test at a significance threshold of p<0.05.
Results: Among the 4,048 patients tested, 140 adult patients (4.87%) and 10 pediatric patients (0.84%) exhibited Anti-HEV IgM reactivity, with significantly higher rates observed in adults. Similarly, adults exhibited a notably higher Anti-HEV IgG reactivity at 40.5%, in contrast to the 7% observed in children. Gender-based analysis revealed no significant differences in Anti-HEV IgM reactivity among adults, while a potential, though weak, difference in Anti-HEV IgG reactivity was observed, with more reactive cases in males.
Conclusion: Our study sheds light on the noteworthy seroprevalence of HEV among hospital admissions patients in the southeastern region of Turkey, surpassing rates reported in other regions. Further research is needed to understand transmission dynamics.

Keywords

Seroprevalence, Hepatitis E Virus, Epidemiology, Immunoglobulin M, Immunoglobulin G

References

• 1. Emerson SU, Pucell RH. Hepatitis E Virus, In: KnipeDM, Howley PM (eds), Fields Virology, 6th ed.Philadelphia: Lippincott Williams&Wilkins, 2013:2242-58.
• 2.Zuckerman AJ. Hepatitis E Virus. BMJ.1990;300:1475-6
• 3.Balayan MS, Andjaparidze AG, Savinskaya SS, et al.Evidence for a virus in non-A, non-B hepatitistransmitted via the fecal-oral route.Intervirology.1983; 20: 23-31.
• 4.Taxon details Paslahepevirusbaleyani. Availableat:https://ictv.global/taxonomy/taxondetails?taxnode_id=202103665
• 5.Adlhoch C, Avellon A, Baylis SA, et al. Hepatitis Evirus: Assessment of the epidemiological situation inhumans in Europe, 2014/15. J ClinVirol.2016; 82: 9–16.
• 6.Khuroo MS, Khuroo MS, Khuroo NS.HepatitisE:Discovery,global impact,control and cure.World JGastroenterol. 2016; 21: 7030-45.
• 7.Albinana-Gimenez N, Clemente-Casares P, Bofill-Mas S, et al. Distribution of human polyomaviruses,adenoviruses, and hepatitis E virus in the environment and in a drinking-water treatment plant. Environ Sci Technol. 2006; 40(23): 7416-22.
• 8.Khuroo MS.Discovery of hepatitis E:the epidemicof non-A,non-B hepatitis 30 years down the memorylane.Virus Res.2011; 161: 3-14.
• 9.Atabek ME, Findik D, Gulyuz A, Erkul I. Prevalenceof anti-HAV and anti-HEV antibodies in Konya,Turkey. Health Policy.2004; 67(3): 265-9.
• 10.Cevrioglu AS, Altindis M, Tanir HM, Aksoy F.Investigation of the incidence of hepatitis E virusamong pregnant women in Turkey. J ObstetGynaecol Res. 2004; 30(1): 48-52.
• 11.Khuroo MS, Kamili S, Jameel S. Verticaltransmission of hepatitis E virus. Lancet. 1995; 345:1025.
• 12.Aggarwal R, Naik S. Epidemiology of hepatitis E:current status. J GastroenterolHepatol.2009; 24(9):1484-93.
• 13. Koksal I, Aydin K, Kardes B, Turgut H, Murt F. Therole of hepatitis E virus in acute sporadic non-A,non-B hepatitis. Infection. 1994; 22(6): 407-10.
• 14.Anderson DA. Hepatitis E virus. In: Mandell GL,Bennett JE, Dolin R, eds. Mandell, Douglas, andBennett’s Principles and Practice of InfectiousDiseases, 7th ed. Philadelphia: ChurchillLivingstone, 2010: 2411-20.
• 15.Thomas DL, Mahley RW, Badur S, Palaoglu KE,Quinn TC. Epidemiology of hepatitis E virus infectionin Turkey. Lancet.1993; 341(8860): 1561-2.
• 16.CakmakTopfedaisiO, Sener A. Seroprevalence ofhepatitis E in hospital employees and investigationof risk factors. Klimik Derg. 2020; 33(1): 44-51.
• 17.Cesur S, Akin K, Dogaroglu I, Birengel S, Balik I.Hepatitis A and hepatitis E seroprevalence in adultsin the Ankara area. Mikrobiyol Bul. 2002; 36(1): 79-83.
• 18.Ertek M, Yazgi H, Yilmaz O, Erol S. ErzurumYöresinde Hepatit E Virüs Seroprevalansı. Flora.2003; 8(1): 65-9.
• 19.Otlu B, Durmaz R. Malatya’da hepatit E virusseropozitifliği. İnfeksiyon Dergisi. 2001; 15: 273-6.
• 20.Uzun KB,Er HH,Gungor S, et al. İzmirKatipÇelebiÜniversitesi Atatürk Eğitim ve AraştırmaHastanesine Başvuran Erişkin Hastalardaki HepatitA ve Hepatit E Seroprevalansı. Viral Hepatit Derg.2013; 19(2): 76-9.
• 21.Aktaş AE, Yiğit N, Ayyildiz A, Yilmaz N. AtatürkÜniversitesi Diş Hekimliği Fakültesi çalışanlarındaAnti HAV ve Anti HEV seroprevalansı. ViralHepatitDerg. 2000; 6: 113-5.
• 22.Uçar E, Cetin M, Kuvandik M, et al. Hatay’dahemodiyaliz tedavisi alan hastalarda hepatit E virusseropozitifliği. Mikrobiyol Bul. 2009; 43: 299-302.
• 23.Yazgi H, Kadanalı A, Ertek M, Gulen A. GebelerdeHepatit E Seroprevalansı. Viral Hepatit Derg. 2003;8: 40-2.
• 24.Eker A, TanselO, Kunduracilar H, et al. HepatitisE virus epidemiology in adult population in Edirneprovince, Turkey. Mikrobiyol Bul. 2009; 43: 251-8.
• 25.Karslıgil T, Ekşi F, Balcı İ, Belgin R. Bölgemizde Ave E Hepatitlerinin Seroprevalansı. Viral HepatitDerg. 2003; 8(3): 155-9.
• 26.Olcay D, Eyigün CP, OzguvenSV, et al. Anti-HEVantibody prevalence in three distinct regions ofTurkey and its relationship with age, gender,education and abortions. Turk J Med Sci. 2003; 33:33– 8.
• 27.Ceylan A, Ertem M, Ozekinci T, Ilçin E. AtıkSuların Tarımda arıtılmadan kullanıldığı DiyarbakırHevsel Bahçeleri’nde çalışanlarda Hepatit-E. ViralHepatit Derg. 2000; 6: 98-101.
• 28.Ozbek E, Temiz H, BatgiAzarkan A, Obut M, MeteS.Doğurganlık Yaşındaki Kadınlarda Hepatit E VirusIgG Seroprevalansının Araştırılması. J ClinExpInvest. 2016; 7(1): 69-72.
• 29.Beskisiz S, Satici O, Kavak V, YalcinK.Determination of Hepatitis E Virus InfectionFrequency and Risk Factors in Viral Hepatitis inDiyarbakır Region. ActaSci Neurol. 2021; 4(7): 54-63.