The hepatitis E virus (HEV, specie Paslahepevirus balayani) is responsible for a liver disease that affects ∼ 20 million people worldwide every year, especially in low- and middle-income countries with poor socioeconomic conditions such as lack of sanitation, low-quality drinking water, or food supply. Although most infections are asymptomatic or with mild symptoms, severe hepatitis, fulminant liver failure, extrahepatic symptoms, and chronic hepatitis can occur in some individuals. Reports of HEV infection worldwide have increased significantly in recent years. However, research has focused on the adult populations. Few studies on HEV in the pediatric population have been carried out, and the impact of the infection, the seroprevalence, burden and molecular epidemiology in this group still remains unknown.
In Argentina only two previous studies of HEV circulation in children have been performed, reporting seroprevalences of 0.15 % and 1.7 %. However, one of them was performed in the 1990s decade, and the other one (performed between 2016 and 2018) was localized to a rural area in the North of the country (Chaco province). With this background, a recent study led by Dr. María Belén Pisano aimed to investigate HEV infection in a children population in Córdoba, an urban central area of Argentina.
A total of 213 serum samples from children and adolescents (age range: 0–18 years old), collected during 2022 in two health centers from the city of Córdoba, were analyzed for HEV detection: 202 samples belonged to individuals attending health-care centers for routine check-ups (group a), and 11 samples from patients with acute hepatitis of unknown etiology (group b). All samples were subjected to RNA-HEV and IgG anti-HEV detection, while only IgG positive and acute samples were subjected to IgM anti-HEV detection.
Seropositivity for IgG anti-HEV (group a) was 1.49 % (3/202) (95 % CI: 0.38–4.63). When divided into categories according to the age, the group over 15 years old had the highest prevalence value (3.57 %, 95 % CI: 0.62–13.38 %). All positive samples belonged to subjects that had access to tap drinking water and only one of them had sewage system at their house. None of the immunosuppressed individuals, with a previous history of blood transfusion, or who had traveled abroad, presented IgG anti-HEV. None of the 3 IgG anti-HEV positive samples were reactive for IgM anti-HEV, and all samples resulted negative for RNA-HEV. One sample from an 18-years-old female patient with acute hepatitis (group b) tested positive for IgM anti-HEV detection, negative for IgG anti-HEV and RNA-HEV, but also positive for IgM anti-EBV.
Overall, the team found a low HEV prevalence among children from an urban area of Argentina. Although previous studies have shown that this virus circulates in the region, infection in children appears to be rare and generally asymptomatic. However, it is crucial to take this agent into consideration since it could cause symptomatic or more severe cases of acute hepatitis when it occurs as a coinfection with other infectious agents or in individuals with underlying pathologies. In this context, the search for HEV in cases of acute hepatitis or severe hepatitis would be recommended.
Read the full article: Heliyon. 2024 Jun 3;10(11):e32284. DOI: 10.1016/j.heliyon.2024.e32284
