Analysis of the sero-epidemiology and clinical impact of Hepatitis E in South America

PISANO, MB; MARTINEZ WASSAF, M.; MIRAZO, S.; LEATHERS, J; FANTILLI, A; DEBES, JD; RÉ, V

Punta Cana

Congreso; XXV Congreso de la Asociación Latinoamericana para el estudio del hígado (ALEH); 2018

Asociación Latinoamericana para el estudio del hígado

Introduction. Hepatitis E virus (HEV) is a frequent cause of acute viral hepatitis of enteric transmission worldwide. In South America, the overall epidemiology and burden of disease remains largely unknown. Objective. To evaluate available data about HEV in South America in order to understand the impact of the virus in the region. Material and methods. We searched published scientific articles regarding HEV in South America by assessment of Pubmed/NLM using the following keywords:HEV, South America, seroprevalence, genotypes, circulation.The search yielded 81 articles and these were evaluated to address the seroprevalence of HEV in human and animal samples, acute and chronic cases as well as associated risk factors in the region. Results. The overall prevalence of HEV IgG in South America among blood donors ranged from 1.8 to 9.8%. Reports from Brazil and Argentina yielded a much higher seroprevalence of HEV among HIV-infected individuals, transplant recipients and patients undergoing hemodialysis. HEV genotype 3 was the most frequently detected genotype in the region, while genotype 1 was only detected in Venezuela and Uruguay. Extra-hepatic manifestations of HEV were rare, with one case of HEV-associated thyroiditis and aplastic anemia reported in Argentina. Chronic HEV was equally rare with only two cases reported in solid-organ transplant recipients. Interestingly, HEV was prevalent in the swine population with rates as high as100% in slaughterhouses of certain Colombian regions. HEV positivity was also reported in wild boars from Uruguay. Conclusions. HEV is widely distributed throughout South America with variable prevalence in humans as well as animals. While there are sporadic cases of acute HEV, chronic infection does not represent a public health issue and extra-hepatic manifestations are uncommon.