Epidemiology of hepatitis E virus in the United States: results from the Third National Health and Nutrition Examination Survey, 1988-1994.
Epidemiology of hepatitis E virus in the United States: results from the Third National Health and Nutrition Examination Survey, 1988-1994.
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DOI：
10.1086/599319
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发表时间：
2009-07-01
期刊：
影响因子：
--
通讯作者：
Nelson KE
中科院分区：
文献类型：
--
作者：
Kuniholm MH;Purcell RH;McQuillan GM;Engle RE;Wasley A;Nelson KE
戊型肝炎病毒 (HEV) 在世界范围内普遍流行并引起疾病，但其流行病学特征仅被部分了解。我们使用酶联免疫分析法测定了第三次全国健康与营养状况调查收集的 18,695 份血清样本中的抗 HEV 免疫球蛋白 G 抗体。我们计算了 HEV 血清流行率的估计值并检查了与假定危险因素的关联。 1988 年至 1994 年期间，美国非机构化平民中 HEV 的血清流行率为 21.0%（95% 置信区间 [CI]，19.0%–22.9%）。在美国出生的个体中，男性、非西班牙裔白人以及居住在中西部和/或大都市地区的个体的血清阳性率估计最高。家中养宠物（比值比 [OR]，1.19 [95% CI，1.01–1.40]）和每月食用肝脏或其他器官肉类一次以上（OR，1.38 [95% CI，1.01–1.88]）与 HEV 血清阳性几率增加显着相关。尽管戊型肝炎很少报道，但接触 HEV 在美国人群中很常见。饲养宠物和食用内脏可能在美国的 HEV 传播中发挥作用，但也可能存在其他传播机制。在没有旅行史的美国患者中，HEV 可能被认为是急性和慢性肝炎的可能病原体。
Hepatitis E virus (HEV) is prevalent and causes disease worldwide, but its epidemiological profile is only partially understood. We used an enzyme immunoassay to measure anti-HEV immunoglobulin G antibodies in 18,695 serum samples collected in the Third National Health and Nutrition Examination Survey. We calculated estimates of HEV seroprevalence and examined associations with putative risk factors. The seroprevalence of HEV in the civilian noninstitutionalized United States (US) population during the period from 1988 through 1994 was 21.0% (95% confidence interval [CI], 19.0%–22.9%). Among US-born individuals, males, non-Hispanic whites, and individuals residing in the Midwest and/or in metropolitan areas had the highest seroprevalence estimates. Having a pet in the home (odds ratio [OR], 1.19 [95% CI, 1.01–1.40]) and consuming liver or other organ meats more than once per month (OR, 1.38 [95% CI, 1.01–1.88]) were significantly associated with increased odds of HEV seropositivity. Exposure to HEV is common in the US population, although hepatitis E is rarely reported. Having pets and consuming organ meats may play a role in HEV transmission in the United States, but other mechanisms of transmission may also exist. HEV may be considered a possible etiologic agent of acute and chronic hepatitis in US patients reporting no travel history.
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