Prevalence and Epidemiology of Hepatitis E Virus in the United States

戊型肝炎病毒（HEV）是导致我国临床肝炎大规模暴发的病原体， 在发展中国家，散发性临床肝炎占很大比例。尽管 尽管HEV无处不在，但在人群中维持流行间HEV的机制仍然很差 明白最近发现了该病毒的一个大型人畜共患宿主， 戊型肝炎病毒通过受污染的肉制品传播，在工业化国家， 这进一步说明人们对戊型肝炎的流行病学知之甚少。 在本申请中，我们建议测试作为第三次国家生物技术试验的一部分收集的储存血清样品。 健康和营养调查（NHANES III）使用高度准确和 在美国国立卫生研究院（NIH）肝炎病毒科开发的经验证的ELISA测定法。 NHANES III是对整个非机构化美国人口的代表性调查 1988年至1994年由疾病控制和预防中心（CDC）进行，包括详细的 评估参与者的人口统计学、职业和食物消费特征。 所有抗HEV检测将在约翰霍普金斯传染病项目（IDP）进行 实验室使用NIH检测。我们将通过在肝炎中心进行2%的样本复检来验证我们的结果。 病毒科，NIH，并与国家卫生中心合作进行中期分析 美国疾病控制和预防中心病毒性肝炎司。 我们期望所提出的项目的结果能够精确估计总体HEV抗体 在美国的流行率，以及提供大量的了解疾病的暴露率， 不同年龄、性别和种族/民族群体。此外，我们希望有出色的能力， 结论性测试假设的流行病学之间的联系戊型肝炎血清阳性和接触 动物，肉类消费和社会经济地位。 该项目将产生迄今为止最全面的HEV流行病学评估， 并将有助于确定可能受益于新开发的高风险群体， 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.