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The epidemiology of hepatitis E virus (HEV) is well described in people who live in or travel to developing countries, where HEV is often spread by fecal–oral transmission or contaminated water. Little is known about the virus in industrialized countries. To assess the prevalence and risk factors for HEV in the U.S., researchers tested serum samples from 18,695 noninstitutionalized people (age, ≥6 years) who participated in the Third National Health and Nutrition Examination Survey from 1988 to 1994.
Sera were tested for anti-HEV antibodies using an enzyme-linked immunosorbent assay developed at the NIH. Overall, 21% of participants were HEV seropositive. The odds of a positive test were significantly greater in pet owners (odds ratio, 1.19) and in participants who consumed liver or other organ meats more than once per month (OR, 1.38). Other significant risk factors were male sex, being born outside the U.S., and living in the Midwest.
Kuniholm MH et al. Epidemiology of hepatitis E virus in the United States: Results from the Third National Health and Nutrition Examination Survey, 1988–1994. J Infect Dis 2009 Jul 1; 200:48.
Comment
These findings suggest that hepatitis E virus is more common in the U.S. than previously thought. Although no test for HEV is licensed in the U.S., testing can be obtained through several commercial laboratories. Knowing that the seroprevalence of HEV is higher should encourage clinicians to consider testing for HEV when patients with suspected hepatitis test negative for hepatitis A, B, and C viruses.