Hepatitis A and E virus infections have different epidemiological patterns in Rwanda

Area of Science:

• Virology
• Epidemiology
• Public Health

Background:

• Hepatitis A virus (HAV) and Hepatitis E virus (HEV) are significant causes of viral hepatitis globally.
• Understanding the prevalence and transmission dynamics of HAV and HEV is crucial for public health interventions in Rwanda.

Purpose of the Study:

• To determine the prevalence of anti-HAV IgG and HEV infection markers in the adult population of Rwanda.
• To investigate potential sources and transmission routes of HAV and HEV in Rwanda.

Main Methods:

• Analysis of serum samples from 1045 blood donors and 1133 healthy adults/liver disease patients for anti-HAV IgG and HEV markers.
• Statistical analysis to assess prevalence across age groups, risk factors, and geographical regions.

Main Results:

• High prevalence of anti-HAV IgG (96.9%) observed, increasing with age, indicating widespread HAV exposure.
• HEV infection markers detected in 11.9% of individuals, with higher prevalence in farmers and specific regions linked to pig density.
• Possible HEV RNA detected in some individuals, including blood donors, but sequencing was not successful.

Conclusions:

• HAV is highly endemic in Rwanda, suggesting a potential decrease in childhood exposure.
• HEV is endemic in Rwanda with moderate spread, possibly transmitted via blood transfusion and from pigs.
• Further research into zoonotic transmission of HEV from pigs is warranted.