engleski

Associated risk factors for hepatitis E seroprevalence among liver transplant recipients

Background and aims: Hepatitis E virus (HEV) is an emerging disease in Europe, especially important among solid organ transplant (SOT) recipients who are at greater risk of developing acute and chronic graft hepatitis with progression to cirrhosis. It is proposed that foodborne transmission is the main route of HEV infection in developed countries. However, risk factors for the acquisition of HEV infection among SOT recipients are incompletely understood. This study aimed to determine exposure of HEV infection and associated socio-demographic risk factors. Background and aims: In this cross-sectional study, 242 Croatian SOT recipients were screened during routine post- transplant outpatient visits. All participants completed a risk factor assessment questionnaire. Blood samples were tested for anti-HEV IgG using an enzyme immune assay (Mikrogen, Germany) and nucleic acid extracts of whole blood were tested by an in- house real-time reverse-transcriptase polymerase chain reaction assay for HEV RNA. Results: Anti-HEV IgG seroprevalence in Croatian SOT recipients was 24.38%. No SOT patients had HEV viraemia at time of testing. The median time after transplant was 5 years (range 19 years). The majority of the recipients were male (69.0%) and major indication for SOTwas alcoholic liver disease (50.4%). Older age (OR = 1.05 ; 95%CI = 1.02-1.09), female gender (OR = 2.61 ; 95%CI = 1.42-4.81), rural area of residence (AOR = 2.17 ; 95%CI = 1.10-4.27), and specific factors within a household: a farm (AOR = 2.79 ; 95% CI = 1.31- 5.92), a water-well (AOR = 3.09 ; 95%CI = 1.11- 8.57) and a sewage system connected to a septic tank (AOR = 3.38 ; 95%CI = 1.64-6.95) were detected as potential risk factors, while highest level of education (AOR = 0.05 ; 95%CI = 0.01- 0.43) and a recent travelling experience (AOR = 0.39 ; 95%CI = 0.17-0.88) as protective factors. Contrary to initial assumptions, production and/or consummation of cured meat and occupational exposure had no statistically significant strength of association with anti-HEV IgG seropositivity. Conclusion: Prevalence of anti-HEV IgG in SOT recipients in Croatia is 24.38%. Identified socio- demographic factors associated with the seropositivity set up a platform for further research directions to evaluate sources/routes of transmission and clinical impact of HEV infection after SOT.

Hepatitis E virus ; Croatia ; liver ; transplantation

nije evidentirano