Prevalence of antibodies to hepatitis E virus in veterinarians working with swine and in normal blood donors in the United States and other countries
Prevalence of antibodies to hepatitis E virus in veterinarians working with swine and in normal blood donors in the United States and other countries
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DOI：
10.1128/jcm.40.1.117-122.2002
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发表时间：
2002-01-01
影响因子：
9.4
通讯作者：
Purcell, RH
中科院分区：
文献类型：
--
作者：
Meng, XJ;Wiseman, B;Purcell, RH
戊型肝炎病毒（HEV）是许多发展中国家和一些工业化国家的地方病。据推测，动物可能是感染源。最近在美国猪中发现的猪戊型肝炎病毒及其跨物种感染能力的证明证实了这一假设。为了评估人畜共患HEV感染的潜在风险，我们对468名与猪打交道的兽医（包括389名美国猪兽医）和400名正常美国献血者进行了免疫球蛋白G抗HEV检测。来自猪HEV的美国毒株和来自人HEV毒株（Sar-55）的重组衣壳抗原各自用于酶联免疫吸附测定。用猪HEV抗原测定的抗-HEV流行率与用人HEV抗原测定的抗-HEV流行率（kappa = 92%）一致性为97%。在来自美国8个州（明尼苏达州、印第安纳州、内布拉斯加州、爱荷华州、伊利诺伊州、密苏里州、北卡罗来纳州和亚拉巴马）的295名接受检测的猪兽医中，26%的人对Sar-55抗原呈阳性，23%的人对猪HEV抗原呈阳性。相比之下，来自美国8个州的献血者中有18%的人Sar-55抗原阳性，17%的人猪HEV抗原阳性。8个州的猪兽医在用猪HEV抗原检测时（95%置信区间，1.03至2.20）和用Sar-55抗原检测时（95%置信区间，0.99至2.17），抗HEV阳性的可能性是正常献血员的1.51倍。我们没有发现有过针刺或割伤经历的兽医和没有过针刺或割伤经历的兽医之间，或者在与猪打交道的时间较长（大于或等于80%的时间）和时间较短（小于或等于20%的时间）的兽医之间，抗-HEV流行率存在差异。同样，我们没有发现抗HEV患病率根据四个工作类别（学术，执业，学生和行业兽医）的差异。在选定的八个州中，猪兽医和献血者的抗-HEV流行率存在差异，明尼苏达州的受试者抗-HEV阳性的可能性是亚拉巴马州的受试者的六倍。年龄不是观察到的州与州之间差异的一个因素。抗-HEV在猪兽医和正常献血员中的流行具有年龄特异性，且随年龄增长而增加。结果表明，猪兽医可能比正常献血者感染HEV的风险更高。
Hepatitis E virus (HEV) is endemic in many developing and some industrialized countries. It has been hypothesized that animals may be the source of infection. The recent identification of swine HEV in U.S. pigs and the demonstration of its ability to infect across species have lent credence to this hypothesis. To assess the potential risk of zoonotic HEV infection, we tested a total of 468 veterinarians working with swine (including 389 U.S. swine veterinarians) and 400 normal U.S. blood donors for immunoglobulin G anti-HEV. Recombinant capsid antigens from a U.S. strain of swine HEV and from a human HEV strain (Sar-55) were each used in an enzyme-linked immunosorbent assay. The anti-HEV prevalence assayed with the swine HEV antigen showed 97% concordance with that obtained with the human HEV antigen (kappa = 92%). Among the 295 swine veterinarians tested from the eight U.S. states (Minnesota, Indiana, Nebraska, Iowa, Illinois, Missouri, North Carolina, and Alabama) from which normal blood donor samples were available, 26% were positive with Sar-55 antigen and 23% were positive with swine HEV antigen. In contrast, 18% of the blood donors from the same eight U.S. states were positive with Sar-55 antigen and 17% were positive with swine HEV antigen. Swine veterinarians in the eight states were 1.51 times more likely when tested with swine HEV antigen (95% confidence interval, 1.03 to 2.20) and 1.46 times more likely when tested with Sar-55 antigen (95% confidence interval, 0.99 to 2.17) to be anti-HEV positive than normal blood donors. We did not find a difference in anti-HEV prevalence between veterinarians who reported having had a needle stick or cut and those who had not or between those who spent more time (greater than or equal to80% of the time) and those who spent less time (less than or equal to20% of the time) working with pigs. Similarly, we did not find a difference in anti-HEV prevalence according to four job categories (academic, practicing, student, and industry veterinarians). There was a difference in anti-HEV prevalence in both swine veterinarians and blood donors among the eight selected states, with subjects from Minnesota six times more likely to be anti-HEV positive than those from Alabama. Age was not a factor in the observed differences from state to state. Anti-HEV prevalence in swine veterinarians and normal blood donors was age specific and paralleled increasing age. The results suggest that swine veterinarians may be at somewhat higher risk of HEV infection than are normal blood donors.