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Prevalence of hepatitis E virus antibodies in children in Germany
Andi Krumbholz1, Anne Neubert, Sebastian Joel
1From the *Institute of Virology and Antiviral Therapy, Jena University Clinic, Friedrich Schiller University of Jena, Jena; †Institute for Infection Medicine, Christian Albrecht University of Kiel, Kiel; ‡Clinic of Pediatrics and Adolescent Medicine, Vivantes Clinic in Friedrichshain, Berlin; §Children's Hospital, Bremen; ¶University Children's Hospital, Pediatric Infectious Diseases, Wuerzburg; ‖HELIOS Children's Hospital, Krefeld; **Department of Paediatrics and Adolescent Medicine, Clinic Dritter Orden, Munich; ††HELIOS Children's Hospital, Erfurt; ‡‡University Children's Hospital Mannheim, Heidelberg University; and §§HELIOS Children´s Hospital, Witten/Herdecke University, Wuppertal, Germany.
Insights
Hepatitis E virus (HEV) seroprevalence in German children aged 0-17 years was 1.0%, with higher rates in adolescents. Standardization of HEV serology assays is needed due to assay variations.
Area of Science:
- Virology
- Immunology
- Pediatrics
Background:
- Asymptomatic Hepatitis E virus (HEV) infections are prevalent in children.
- Limited data exists on HEV seroprevalence in infants, children, and adolescents.
- Understanding HEV epidemiology in pediatric populations is crucial.
Purpose of the Study:
- To determine the seroprevalence of HEV in a German pediatric population.
- To analyze HEV seroprevalence across different age groups within childhood and adolescence.
- To evaluate the performance of different HEV antibody detection assays.
Main Methods:
- Sera from 1646 children (aged 0-17 years) collected in Germany (2008-2010) were tested for anti-HEV IgG antibodies.
- Enzyme-linked immunosorbent assays (ELISAs) including recomWell HEV IgG, recomLine HEV IgG/IgM, MP Biomedicals HEV, and Axiom HEV-Ab were utilized.
- Assay performance was compared using a subset of sera.
Main Results:
- Overall HEV seroprevalence in children was 1.0%.
- Seroprevalence increased significantly from 1.5% in 5-6 year olds to 1.5% in 15-17 year olds.
- No significant difference in seroprevalence was observed between boys (1.2%) and girls (0.7%).
- Passively transferred maternal antibodies were detected for approximately 3 months.
- Inter-assay agreement varied significantly (0.229–0.542), with low agreement between MP Biomedicals and Axiom assays (0.111).
Conclusions:
- HEV infections are infrequent in German children, with most infections occurring in adults.
- Significant variations in HEV serological assay performance highlight the need for standardization.
- Further research is required to ensure accurate and reliable HEV diagnostics in pediatric populations.
Background:
Since asymptomatic hepatitis E virus (HEV) infections particularly affect children, there is a need for studies to determine the HEV seroprevalence among infants, children and adolescents.
Methods:
The prevalence of anti-HEV IgG antibodies was determined in sera taken in 2008-2010 from 1646 children aged 0-17 years living in Germany. Antibody testing was carried out using the enzyme-linked immunosorbent assay recomWell HEV IgG as well as the recomLine HEV IgG/IgM distributed by Mikrogen. Furthermore, the performance of MP Biomedicals enzyme-linked immunosorbent assay HEV and the HEV-Ab enzyme-linked immunosorbent assay from Axiom was analyzed in comparison with the recomWell/recomLine test system using a defined subset of sera.
Results:
In children, the overall prevalence of antibodies was 1.0%. Starting with the 5- to 6-year olds, there was a significant increase of HEV seroprevalence to 1.5% in the group of the 15- to 17-year olds. There was no statistically significant difference between seroprevalences of boys (1.2%) and girls (0.7%). Passively transmitted maternal antibodies persisted for about 3 months. The strength of agreement between the recomWell/recomLine system and the ELISAs from MP Biomedicals or Axiom varied between 0.229 and 0.542 and was calculated at 0.111 when the assays from MP Biomedicals and Axiom were compared.
Conclusions:
In Germany, only a very small number of HEV infections occur in children. Many infections occur in adults with increasing age. Because of considerable variations in assay accordance, there is an urgent need for standardization of HEV serology.
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