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HEV prevalence varies in France

Hepatitis E virus infection was endemic in only certain parts of France. This prevalence was due to dietary habits of the population and water contamination, according to results of a cross-sectional study.

Jean Michel Mansuy, MD, of the virology department at the Federative Institute of Biology, France, and colleagues administered a questionnaire to gather epidemiological data from 10,569 French blood donors living in mainland France and three overseas areas. The questionnaire consisted of questions related to demographics and factors associated with the presence of anti-HEV, such as what type of dwelling the person lived in, professional activities, travel history outside of Europe and details of its wastewater system. The researchers used validated assays to determine the prevalence of anti-HEV immunoglobulin G (IgG) and immunoglobulin M (IgM).

“Most cases of hepatitis E viral infection in developed countries are autochthonous. Nevertheless, the reported seroprevalence of HEV varies greatly depending on the geographical area and the performance of the immunoassay used,” the researchers wrote. “We looked for factors that might be associated with [the presence of anti-HEV IgG and IgM] … in order to identify potential risk of exposure to HEV.”

The overall IgG seroprevalence was 22.4% (95% CI, 21.6-23.2). IgG seroprevalence was higher in donors who were aged older than 45 years (30.7%) compared with younger donors (14.7%; P < .001) and higher in men compared with women (25% vs. 19.5%).

The presence of anti-HEV IgG was associated with increasing age (P < .001) and eating pork meat (P = .03), pork liver sausages (P < .001), game meat (P < .01), offal (P < .001) and oysters (P = .02), whereas drinking bottled water was associated with a lower rate of anti-HEV IgG (P = .02).

The overall IgM seroprevalence was 1% (95% CI, 0.8-1.2). The rate of anti-HEV IgM was higher in donors living in a high anti-HEV IgG seroprevalence geographic area (1.9% vs. 0.7%; P < .001) and in donors eating pork liver sausage (1.4% vs. 0.7%; P < .01), pâté (1% vs. 0.4%; P = .04) and wild boar (1.3% vs. 0.7%; P < .01).

“HEV is endemic in France and hyperendemic in some areas,” the researchers concluded. “Eating habits alone cannot totally explain the exposure to HEV, and contaminated water could contribute to the epidemiology of HEV infection in France.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.