Epidemiology of zoonotic hepatitis E: a community-based surveillance study in a rural population in China

PLoS One. 2014 Jan 31;9(1):e87154. doi: 10.1371/journal.pone.0087154. eCollection 2014.

Abstract

Background: Hepatitis E is caused by two viral genotype groups: human types and zoonotic types. Current understanding of the epidemiology of the zoonotic hepatitis E disease is founded largely on hospital-based studies.

Methods: The epidemiology of hepatitis E was investigated in a community-based surveillance study conducted over one year in a rural city in eastern China with a registered population of 400,162.

Results: The seroprevalence of hepatitis E in the cohort was 38%. The incidence of hepatitis E was 2.8/10,000 person-years. Totally 93.5% of the infections were attributed to genotype 4 and the rest, to genotype 1. Hepatitis E accounted for 28.4% (102/359) of the acute hepatitis cases and 68.9% (102/148) of the acute viral hepatitis cases in this area of China. The disease occurred sporadically with a higher prevalence during the cold season and in men, with the male-to-female ratio of 3∶1. Additionally, the incidence of hepatitis E increased with age. Hepatitis B virus carriers have an increased risk of contracting hepatitis E than the general population (OR = 2.5, 95%CI 1.5-4.2). Pre-existing immunity to hepatitis E lowered the risk (relative risk = 0.34, 95% CI 0.21-0.55) and reduced the severity of the disease.

Conclusions: Hepatitis E in the rural population of China is essentially that of a zoonosis due to the genotype 4 virus, the epidemiology of which is similar to that due to the other zoonotic genotype 3 virus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Animals
  • Antibodies, Viral / blood
  • Antibodies, Viral / immunology
  • Asian People / statistics & numerical data
  • Child
  • China / epidemiology
  • Cold Temperature
  • Female
  • Genotype
  • Hepatitis E / epidemiology*
  • Hepatitis E / ethnology
  • Hepatitis E / virology
  • Hepatitis E virus / genetics
  • Hepatitis E virus / immunology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Population Surveillance / methods*
  • Risk Factors
  • Rural Population / statistics & numerical data*
  • Seasons
  • Seroepidemiologic Studies
  • Sex Factors
  • Zoonoses / epidemiology*
  • Zoonoses / ethnology
  • Zoonoses / virology

Substances

  • Antibodies, Viral

Grants and funding

The work was supported by National Major Scientific and Technological Special Project for “Significant New Drugs Development” (2013ZX09101017); National High-tech Research & Development Program (863 Program) (2012AA02A408); National Major Scientific and Technological Special Project for “Prevention and Control of important infectious diseases” (2012ZX10002001, 2011ZX10004-903) (http://www.most.gov.cn/); Fujian Provincial Science Fund for Distinguished Young Scholars (2011J06015) (http://www.fjkjt.gov.cn/)and Jiangsu science and technology support plan project (BE2013723). However, the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.