Prevalence and Epidemiology of Hepatitis E Virus in the United States

戊型肝炎病毒(HEV)是导致临床肝炎大规模爆发的病原体。 在发展中国家，散发性临床肝炎占很大比例。尽管它的 无处不在，维持人群间流行的HEV的机制仍然很差 明白了。最近发现了一个大型人畜共患病病毒宿主，可通过食物传播 通过受污染的肉类产品传播的HEV，以及工业化国家的大量HEV血清阳性率 强调了人们对HEV流行病学知之甚少。 在这项申请中，我们建议测试作为第三次国家 健康和营养调查(NHANES III)使用高精度和 由美国国立卫生研究院(NIH)肝炎病毒科开发的经验证的ELISA法。 NHANES III是对整个非制度化美国人口的代表性调查 由疾病控制和预防中心(CDC)在1988-94年间进行，包括详细的 对参与者的人口、职业和食物消费特征进行评估。 所有抗-HEV检测将在约翰·霍普金斯传染病项目(IDP)进行。 使用美国国立卫生研究院化验的实验室。我们将通过在肝炎中心进行2%的样本重新测试来验证我们的结果 NIH病毒科，并与国家健康中心合作进行中期分析 疾病预防控制中心和疾病预防控制中心病毒性肝炎处。 我们期望拟议项目的结果能给出整体HEV抗体的准确估计。 在美国的流行率，以及对以下人群疾病暴露比率的实质性洞察 不同年龄、性别和种族/民族群体。此外，我们希望拥有出色的能力来 结论测试假设的HEV血清阳性与接触者之间的流行病学联系 动物、肉类消费和社会经济地位。 该项目将产生迄今可用的最全面的HEV流行病学评估， 并将帮助确定可能受益于新开发和高度集中的 有效的HEV疫苗。

Hepatitis E virus (HEV) is the etiologic agent responsible for large outbreaks of clinical hepatitis in developing countries and a large proportion of sporadic clinical hepatitis in developing countries. Despite its omnipresence, the mechanism for maintenance of inter-epidemic HEV in populations remains poorly understood. The recent discoveries of a large zoonotic reservoir for the virus, food-bornetransmission of HEV via contaminated meat products, and substantial HEV seroprevalence in industrialized countries have reinforced how little is known about the epidemiology of HEV. In this application we propose to test stored serum samples collected as a part of the third National Health and Nutrition Survey (NHANES III)for the presence of anti-HEV IgG using a highly accurate and validated ELISA assay developed at the Hepatitis Viruses Section, National Institutes of Health (NIH). NHANES III was a representative survey of the entire non-institutionalized United States population conducted from 1988-94 by the Centers for Disease Control and Prevention (CDC) and included detailed assessment of demographic, occupational, and food consumption characteristics of its participants. All anti-HEV testing will be conducted at the Johns Hopkins Infectious Disease Program (IDP) laboratories using the NIH assay. We will validate our results via a 2% sample re-testing at the Hepatitis Virus Section, NIH, and conduct interim analyses in collaboration with the National Center for Health Statistics, CDC and the Division of Viral Hepatitis, CDC. We expect the results of the proposed project to give a precise estimate of overall HEV antibody prevalence in the United States, as well give substantial insight into rates of disease exposure among various age, gender, and racial/ethnic groups. Additionally, we expect to have excellent power to conclusively test postulated epidemiologic associations between HEV seropositivity and contact with animals, meat consumption, and socioeconomic status. This project will produce the most comprehensive assessment of HEV epidemiology available to date, and will aid in the identification of at-risk groups that may benefit from the newly developed and highly efficacious HEV vaccine.