TY - JOUR
T1 - Epidemiology of hepatitis E virus in the United States
T2 - Results from the third national health and nutrition examination survey, 1988-1994
AU - Kuniholm, Mark H.
AU - Pureell, Robert H.
AU - McQuillan, Geraldine M.
AU - Engle, Ronald E.
AU - Wasley, Annemarie
AU - Nelson, Kenrad E.
N1 - Funding Information:
Financial support: Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH) (R.H.P. and R.E.E.); NIAID, NIH (grant 1R21AI067449–01A1 to K.E.N.) Presented in part: Viral Hepatitis Prevention Board Meeting: Hepatitis A and E, Update on Prevention and Epidemiology, Antwerp, Belgium, 13 March 2009; 13th International Symposium on Viral Hepatitis and Liver Disease, Washington, DC, 21 March 2009 (abstract PL-1).
PY - 2009/7/1
Y1 - 2009/7/1
N2 - Background. Hepatitis E virus (HEV) is prevalent and causes disease worldwide, but its epidemiological profile is only partially understood. Methods. We used an enzyme immunoassay to measure anti-HEV immunoglobulin G antibodies in 18,695 serum samples collected in the Third National Health and Nutrition Examination Survey. We calculated estimates of HEV seroprevalence and examined associations with putative risk factors. Results. The seroprevalence of HEV in the civilian noninstitutionalized United States (US) population during the period from 1988 through 1994 was 21.0% (95% confidence interval [CI], 19.0%-22.9%). Among US-born individuals, males, non-Hispanic whites, and individuals residing in the Midwest and/or in metropolitan areas had the highest seroprevalence estimates. Having a pet in the home (odds ratio [OR], 1.19 [95% CI, 1.01-1.40]) and consuming liver or other organ meats more than once per month (OR, 1.38 [95% CI, 1.01-1.88]) were significantly associated with increased odds of HEV seropositivity. Conclusions. Exposure to HEV is common in the US population, although hepatitis E is rarely reported. Having pets and consuming organ meats may play a role in HEV transmission in the United States, but other mechanisms of transmission may also exist. HEV may be considered a possible etiologic agent of acute and chronic hepatitis in US patients reporting no travel history.
AB - Background. Hepatitis E virus (HEV) is prevalent and causes disease worldwide, but its epidemiological profile is only partially understood. Methods. We used an enzyme immunoassay to measure anti-HEV immunoglobulin G antibodies in 18,695 serum samples collected in the Third National Health and Nutrition Examination Survey. We calculated estimates of HEV seroprevalence and examined associations with putative risk factors. Results. The seroprevalence of HEV in the civilian noninstitutionalized United States (US) population during the period from 1988 through 1994 was 21.0% (95% confidence interval [CI], 19.0%-22.9%). Among US-born individuals, males, non-Hispanic whites, and individuals residing in the Midwest and/or in metropolitan areas had the highest seroprevalence estimates. Having a pet in the home (odds ratio [OR], 1.19 [95% CI, 1.01-1.40]) and consuming liver or other organ meats more than once per month (OR, 1.38 [95% CI, 1.01-1.88]) were significantly associated with increased odds of HEV seropositivity. Conclusions. Exposure to HEV is common in the US population, although hepatitis E is rarely reported. Having pets and consuming organ meats may play a role in HEV transmission in the United States, but other mechanisms of transmission may also exist. HEV may be considered a possible etiologic agent of acute and chronic hepatitis in US patients reporting no travel history.
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U2 - 10.1086/599319
DO - 10.1086/599319
M3 - Article
C2 - 19473098
AN - SCOPUS:67650663505
SN - 0022-1899
VL - 200
SP - 48
EP - 56
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 1
ER -