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Hepatitis E in Singapore--a seroprevalence study

W C Chow1, H S Ng, G K Lim

  • 1Department of Gastroenterology, Singapore General Hospital, Singapore.

Singapore Medical Journal
|December 1, 1996
PubMed
Summary

Hepatitis E IgG antibodies were found in 10.5% of the general population and 14.7% of liver disease patients, indicating local transmission and potential subclinical infections. Antibodies persisted over 12 months, common in older adults.

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Immunology

Background:

  • Hepatitis E virus (HEV) infection is a significant public health concern globally.
  • Understanding the seroprevalence of HEV is crucial for assessing disease burden and transmission dynamics.
  • Previous studies often focused on travelers, necessitating data from local populations.

Purpose of the Study:

  • To determine the seroprevalence of antibodies to Hepatitis E virus (anti-HEV IgG) in a hospital-based population.
  • To compare seroprevalence between a general medical population and patients with liver disorders.
  • To investigate potential associations with Hepatitis A virus (HAV) and factors like age and travel history.

Main Methods:

  • Cross-sectional study involving patients admitted to a general medical unit.

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  • Blood samples analyzed for the presence of anti-HEV IgG and anti-HAV IgG.
  • Patients categorized into 'healthy' (admitted for non-hepatological conditions) and 'liver disease' groups.
  • Antibody persistence retested in a subset of positive cases.

    • Main Results:

    • The seroprevalence of anti-HEV IgG was 10.5% in the 'healthy' group and 14.7% in the liver disease group.
    • Lack of travel history suggests local HEV transmission and possible subclinical infections.
    • A significant association was observed between anti-HAV IgG and anti-HEV IgG seroprevalence.
    • Anti-HAV IgG showed a higher overall seroprevalence compared to anti-HEV IgG.
    • Antibodies to both HEV and HAV were more prevalent in older age groups.
    • Anti-HEV IgG antibodies persisted beyond 12 months in retested individuals.

    Conclusions:

    • Hepatitis E infection is present in the local population, with a notable seroprevalence in both general and liver disease patient cohorts.
    • The co-occurrence of Hepatitis A and E antibodies suggests shared risk factors or exposure pathways.
    • Age is a significant factor associated with HEV and HAV seropositivity, with higher rates in older individuals.
    • The persistence of anti-HEV IgG antibodies indicates long-term immunity or past exposure, while subclinical cases may contribute to local transmission.