Hepatitis E Virus in Water Environments: A Systematic Review and Meta-analysis

Area of Science:

• Environmental Science
• Virology
• Public Health

Background:

• Hepatitis E virus (HEV) causes acute hepatitis through foodborne, zoonotic, and waterborne transmission.
• Understanding HEV prevalence in diverse water matrices is crucial for public health.
• HEV transmission via water is well-documented in developing countries, but less understood in industrialized ones.

Purpose of the Study:

• To assess the prevalence of Hepatitis E virus (HEV) across various water environments globally.
• To identify water categories with higher HEV prevalence.
• To analyze HEV genotypes found in water samples.

Main Methods:

• Systematic literature review of HEV prevalence studies in water.
• Searched PubMed, Web of Science, Global Index Medicus, and EMBASE databases.
• Included 87 prevalence studies from 58 papers, with data extraction and heterogeneity assessment.

Main Results:

• Overall HEV prevalence in water was 9.8%, highest in untreated wastewater (15.1%) and lowest in treated wastewater (3.8%) and drinking water (4.7%).
• HEV genotype 3 was most prevalent, followed by HEV-1.
• Prevalence was higher in industrialized countries, despite better sanitation.

Conclusions:

• HEV occurs in various water environments, including those in industrialized countries with advanced water treatment.
• Further research is needed on HEV sources, occurrence, survival, and removal in water to clarify transmission pathways.
• The potential for HEV waterborne transmission in industrialized nations requires further investigation.