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Abstract

Background

Hepatitis E virus (HEV) is an emerging public health concern in high-income countries and can cause acute and chronic hepatitis. Reported numbers of indigenously acquired HEV infection have increased in the past decade in many European countries. Since 2010, the National Reference Centre (NRC) for Hepatitis Viruses has been testing samples of suspected hepatitis E cases in Belgium.

Aim

In this surveillance report, we present the epidemiological trends of symptomatic HEV infections in Belgium, from the distribution by age, sex and geography to the molecular characterisation of the viral strains.

Method

Serum samples of suspected cases sent to the NRC between 2010 and 2017 were analysed for the presence of HEV-specific IgM and RNA. Virus was sequenced for genotyping and phylogenetic analysis in all samples containing sufficient viral RNA.

Results

The NRC reported an increase in the number of samples from suspected cases (from 309 to 2,663 per year) and in the number of laboratory-confirmed hepatitis E cases (from 25 to 117 per year). Among 217 sequenced samples, 92.6% were genotype 3 (HEV-3), followed by 6.5% of genotype 1 and 0.9% of genotype 4. HEV-3 subtype viruses were mainly 3f, 3c and 3e. HEV-3f was the most common subtype until 2015, while HEV-3c became the most common subtype in 2016 and 2017.

Conclusion

The increasing trend of HEV diagnoses in Belgium may be largely explained by increased awareness and testing.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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/content/10.2807/1560-7917.ES.2019.24.10.1800141
2019-03-07
2024-04-16
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.10.1800141
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References

  1. Dalton HR, Stableforth W, Hazeldine S, Thurairajah P, Ramnarace R, Warshow U, et al. Autochthonous hepatitis E in Southwest England: a comparison with hepatitis A. Eur J Clin Microbiol Infect Dis. 2008;27(7):579-85.  https://doi.org/10.1007/s10096-008-0480-z  PMID: 18299907 
  2. Kamar N, Izopet J, Pavio N, Aggarwal R, Labrique A, Wedemeyer H, et al. Hepatitis E virus infection. Nat Rev Dis Primers. 2017;3:17086.  https://doi.org/10.1038/nrdp.2017.86  PMID: 29154369 
  3. Nimgaonkar I, Ding Q, Schwartz RE, Ploss A. Hepatitis E virus: advances and challenges. Nat Rev Gastroenterol Hepatol. 2018;15(2):96-110.  https://doi.org/10.1038/nrgastro.2017.150  PMID: 29162935 
  4. Mansuy JM, Saune K, Rech H, Abravanel F, Mengelle C, L Homme S, et al. Seroprevalence in blood donors reveals widespread, multi-source exposure to hepatitis E virus, southern France, October 2011. Euro Surveill. 2015;20(19):27-34.  https://doi.org/10.2807/1560-7917.ES2015.20.19.21127  PMID: 25990359 
  5. Lucarelli C, Spada E, Taliani G, Chionne P, Madonna E, Marcantonio C, et al. High prevalence of anti-hepatitis E virus antibodies among blood donors in central Italy, February to March 2014. Euro Surveill. 2016;21(30):30299.  https://doi.org/10.2807/1560-7917.ES.2016.21.30.30299  PMID: 27494608 
  6. Domanović D, Tedder R, Blümel J, Zaaijer H, Gallian P, Niederhauser C, et al. Hepatitis E and blood donation safety in selected European countries: a shift to screening? Euro Surveill. 2017;22(16):30514.  https://doi.org/10.2807/1560-7917.ES.2017.22.16.30514  PMID: 28449730 
  7. Hartl J, Otto B, Madden RG, Webb G, Woolson KL, Kriston L, et al. Hepatitis E seroprevalence in Europe: a meta-analysis. Viruses. 2016;8(8):E211.  https://doi.org/10.3390/v8080211  PMID: 27509518 
  8. Mansuy JM, Gallian P, Dimeglio C, Saune K, Arnaud C, Pelletier B, et al. A nationwide survey of hepatitis E viral infection in French blood donors. Hepatology. 2016;63(4):1145-54.  https://doi.org/10.1002/hep.28436  PMID: 27008201 
  9. Van Hoecke F, Van Maerken T, De Boulle M, Geerts A, Vlierberghe V, Colle I, et al. Hepatitis E seroprevalence in east and west Flanders, Belgium. Acta Gastroenterol Belg. 2012;75(3):322-4. PMID: 23082702 
  10. Thiry D, Mauroy A, Saegerman C, Thomas I, Wautier M, Miry C, et al. Estimation of hepatitis E virus (HEV) pig seroprevalence using ELISA and Western blot and comparison between human and pig HEV sequences in Belgium. Vet Microbiol. 2014;172(3-4):407-14.  https://doi.org/10.1016/j.vetmic.2014.06.004  PMID: 24975642 
  11. Grierson S, Heaney J, Cheney T, Morgan D, Wyllie S, Powell L, et al. Prevalence of hepatitis E Virus infection in pigs at the time of slaughter, United Kingdom, 2013. Emerg Infect Dis. 2015;21(8):1396-401.  https://doi.org/10.3201/eid2108.141995  PMID: 26196216 
  12. Crossan C, Grierson S, Thomson J, Ward A, Nunez-Garcia J, Banks M, et al. Prevalence of hepatitis E virus in slaughter-age pigs in Scotland. Epidemiol Infect. 2015;143(10):2237-40.  https://doi.org/10.1017/S0950268814003100  PMID: 25410494 
  13. Feurer C, Le Roux A, Rossel R, Barnaud E, Dumarest M, Garry P, et al. High load of hepatitis E viral RNA in pork livers but absence in pork muscle at French slaughterhouses. Int J Food Microbiol. 2018;264:25-30.  https://doi.org/10.1016/j.ijfoodmicro.2017.10.013  PMID: 29107193 
  14. Hummel KB, Lowe L, Bellini WJ, Rota PA. Development of quantitative gene-specific real-time RT-PCR assays for the detection of measles virus in clinical specimens. J Virol Methods. 2006;132(1-2):166-73.  https://doi.org/10.1016/j.jviromet.2005.10.006  PMID: 16274752 
  15. Huang FF, Haqshenas G, Guenette DK, Halbur PG, Schommer SK, Pierson FW, et al. Detection by reverse transcription-PCR and genetic characterization of field isolates of swine hepatitis E virus from pigs in different geographic regions of the United States. J Clin Microbiol. 2002;40(4):1326-32.  https://doi.org/10.1128/JCM.40.4.1326-1332.2002  PMID: 11923352 
  16. Boxman ILA, Jansen CCC, Hägele G, Zwartkruis-Nahuis A, Cremer J, Vennema H, et al. Porcine blood used as ingredient in meat productions may serve as a vehicle for hepatitis E virus transmission. Int J Food Microbiol. 2017;257:225-31.  https://doi.org/10.1016/j.ijfoodmicro.2017.06.029  PMID: 28692890 
  17. Smith DB, Simmonds P, Izopet J, Oliveira-Filho EF, Ulrich RG, Johne R, et al. Proposed reference sequences for hepatitis E virus subtypes. J Gen Virol. 2016;97(3):537-42.  https://doi.org/10.1099/jgv.0.000393  PMID: 26743685 
  18. Tamura K, Peterson D, Peterson N, Stecher G, Nei M, Kumar S. MEGA5: molecular evolutionary genetics analysis using maximum likelihood, evolutionary distance, and maximum parsimony methods. Mol Biol Evol. 2011;28(10):2731-9.  https://doi.org/10.1093/molbev/msr121  PMID: 21546353 
  19. van der Poel WH, Verschoor F, van der Heide R, Herrera MI, Vivo A, Kooreman M, et al. Hepatitis E virus sequences in swine related to sequences in humans, The Netherlands. Emerg Infect Dis. 2001;7(6):970-6.  https://doi.org/10.3201/eid0706.010608  PMID: 11747723 
  20. Adlhoch C, Avellon A, Baylis SA, Ciccaglione AR, Couturier E, de Sousa R, et al. Hepatitis E virus: Assessment of the epidemiological situation in humans in Europe, 2014/15. J Clin Virol. 2016;82:9-16.  https://doi.org/10.1016/j.jcv.2016.06.010  PMID: 27393938 
  21. Aspinall EJ, Couturier E, Faber M, Said B, Ijaz S, Tavoschi L, et al. Hepatitis E virus infection in Europe: surveillance and descriptive epidemiology of confirmed cases, 2005 to 2015. Euro Surveill. 2017;22(26): 30561.  https://doi.org/10.2807/1560-7917.ES.2017.22.26.30561  PMID: 28681720 
  22. Faber M, Willrich N, Schemmerer M, Rauh C, Kuhnert R, Stark K, et al. Hepatitis E virus seroprevalence, seroincidence and seroreversion in the German adult population. J Viral Hepat. 2018;25(6):752-8.  https://doi.org/10.1111/jvh.12868  PMID: 29377436 
  23. Mansuy JM, Gallian P, Dimeglio C, Saune K, Arnaud C, Pelletier B, et al. A nationwide survey of hepatitis E viral infection in French blood donors. Hepatology. 2016;63(4):1145-54.  https://doi.org/10.1002/hep.28436  PMID: 27008201 
  24. Ijaz S, Said B, Boxall E, Smit E, Morgan D, Tedder RS. Indigenous hepatitis E in England and wales from 2003 to 2012: evidence of an emerging novel phylotype of viruses. J Infect Dis. 2014;209(8):1212-8.  https://doi.org/10.1093/infdis/jit652  PMID: 24273173 
  25. Said B, Ijaz S, Chand MA, Kafatos G, Tedder R, Morgan D. Hepatitis E virus in England and Wales: indigenous infection is associated with the consumption of processed pork products. Epidemiol Infect. 2014;142(7):1467-75.  https://doi.org/10.1017/S0950268813002318  PMID: 24054519 
  26. Said B, Usdin M, Warburton F, Ijaz S, Tedder RS, Morgan D. Pork products associated with human infection caused by an emerging phylotype of hepatitis E virus in England and Wales. Epidemiol Infect. 2017;145(12):2417-23.  https://doi.org/10.1017/S0950268817001388  PMID: 28756783 
  27. Mykytczuk O, Harlow J, Bidawid S, Corneau N, Nasheri N. Prevalence and molecular characterization of the hepatitis E virus in retail pork products marketed in Canada. Food Environ Virol. 2017;9(2):208-18.  https://doi.org/10.1007/s12560-017-9281-9  PMID: 28197972 
Epidemiology and genotype 3 subtype dynamics of hepatitis E virus in Belgium, 2010 to 2017
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Vanessa+Suin&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Suin Vanessa</a>, <a href="/search?value1=Sofieke+E+Klamer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Klamer Sofieke E</a>, <a href="/search?value1=Veronik+Hutse&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hutse Veronik</a>, <a href="/search?value1=Magali+Wautier&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wautier Magali</a>, <a href="/search?value1=Marjorie+Jacques&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jacques Marjorie</a>, <a href="/search?value1=Mona+Abady&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Abady Mona</a>, <a href="/search?value1=Sophie+Lamoral&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lamoral Sophie</a>, <a href="/search?value1=Vera+Verburgh&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Verburgh Vera</a>, <a href="/search?value1=Isabelle+Thomas&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Thomas Isabelle</a>, <a href="/search?value1=Bernard+Brochier&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Brochier Bernard</a>, <a href="/search?value1=Lorenzo+Subissi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Subissi Lorenzo</a>, <a href="/search?value1=Steven+Van+Gucht&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Van Gucht Steven</a></span>. Epidemiology and genotype 3 subtype dynamics of hepatitis E virus in Belgium, 2010 to 2017. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(10):pii=1800141. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.10.1800141" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.10.1800141</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 19 Mar 2018;&nbsp;&nbsp; <span class="generated">Accepted</span>: 08 Jan 2019 </span> </p>
/content/10.2807/1560-7917.ES.2019.24.10.1800141
/content/10.2807/1560-7917.ES.2019.24.10.1800141
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