scholarly journals Epidemiology of Hepatitis E in 2017 in Bavaria, Germany

2021 ◽  
Author(s):  
K. Hriskova ◽  
D. Marosevic ◽  
A. Belting ◽  
J. J. Wenzel ◽  
A. Carl ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis E ◽  
Food Samples ◽  
Healthy Population ◽  
Genotype 3 ◽  
Human Samples ◽  
Multivariable Analyses ◽  
Upper Abdominal ◽  
Undercooked Meat

AbstractIn the last decade, the number of reported hepatitis E virus (HEV) infections in Germany, including Bavaria, has continued to rise. In order to identify risk factors associated with HEV infection, we investigated notified hepatitis E cases from Bavaria during 2017. The project “Intensified Hepatitis E Surveillance in Bavaria” included interviews with questionnaires, collection and genotyping of stool, serum and food samples. In addition, certain risk factors were examined in a sample comparison with healthy population using univariable analysis and logistic regression. In total, 135 hepatitis E cases from Bavaria were included in the analysis. Mean age for women was 46 (range 20–74) years and 47.5 (range 20–85) for men. 56 of the cases (41.5%) were asymptomatic. Among the symptomatic cases, both men and women were equally affected with symptoms like fever (16.3%), jaundice (18.8%) and upper abdominal pain (28.2%). 145 human samples (serum, stool) and 6 food samples were collected. 15.9% of the human samples (n = 23) were positive for HEV RNA by reverse-transcription quantitative real-time PCR (RT-qPCR). Identified risk factors significantly associated with hepatitis E were sausage consumption with odds ratio 9.6 (CI 1.3–70.1), fish with OR 2.2 (CI 1.1–4.4) and cat ownership with OR 1.9 (CI 1.3–3.0) in multivariable analyses. Further investigation is needed to confirm the role of fish in HEV transmission. Autochthonous HEV genotype 3 is prevalent in Bavaria and there could be more transmission routes contributing to the spread of HEV than previously known. Undercooked meat, offal, sausages, fish, shellfish and contact with animals and pets are possible sources for infection.

scholarly journals Infection dynamics and persistence of hepatitis E virus on pig farms – a review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
M. Meester ◽  
T. J. Tobias ◽  
M. Bouwknegt ◽  
N. E. Kusters ◽  
J. A. Stegeman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis E Virus ◽  
Risk Mitigation ◽  
Transmission Rate ◽  
Hepatitis E ◽  
Main Body ◽  
Genotype 3 ◽  
Infection Dynamics ◽  
Pig Farms ◽  
Slaughter Pigs

Abstract Background Hepatitis E virus (HEV) genotype 3 and 4 is a zoonosis that causes hepatitis in humans. Humans can become infected by consumption of pork or contact with pigs. Pigs are the main reservoir of the virus worldwide and the virus is present on most pig farms. Main body Though HEV is present on most farms, the proportion of infected pigs at slaughter and thus the level of exposure to consumers differs between farms and countries. Understanding the cause of that difference is necessary to install effective measures to lower HEV in pigs at slaughter. Here, HEV studies are reviewed that include infection dynamics of HEV in pigs and on farms, risk factors for HEV farm prevalence, and that describe mechanisms and sources that could generate persistence on farms. Most pigs become infected after maternal immunity has waned, at the end of the nursing or beginning of the fattening phase. Risk factors increasing the likelihood of a high farm prevalence or proportion of actively infected slaughter pigs comprise of factors such as farm demographics, internal and external biosecurity and immunomodulating coinfections. On-farm persistence of HEV is plausible, because of a high transmission rate and a constant influx of susceptible pigs. Environmental sources of HEV that enhance persistence are contaminated manure storages, water and fomites. Conclusion As HEV is persistently present on most pig farms, current risk mitigation should focus on lowering transmission within farms, especially between farm compartments. Yet, one should be aware of the paradox of increasing the proportion of actively infected pigs at slaughter by reducing transmission insufficiently. Vaccination of pigs may aid HEV control in the future.

scholarly journals Effector memory CD8 T cell response elicits Hepatitis E Virus genotype 3 pathogenesis in the elderly

2021 ◽  
Vol 17 (2) ◽  
pp. e1009367
Author(s):  
Hicham El Costa ◽  
Jordi Gouilly ◽  
Florence Abravanel ◽  
Elmostafa Bahraoui ◽  
Jean-Marie Peron ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Response ◽  
Hepatitis E Virus ◽  
Clinical Symptoms ◽  
Hepatitis E ◽  
Effector Memory ◽  
Elderly Subjects ◽  
Antigen Specificity ◽  
Genotype 3

Genotype 3 Hepatitis E virus (HEV-3) is an emerging threat for aging population. More than one third of older infected patients develops clinical symptoms with severe liver damage, while others remain asymptomatic. The origin of this discrepancy is still elusive although HEV-3 pathogenesis appears to be immune-mediated. Therefore, we investigated the role of CD8 T cells in the outcome of the infection in immunocompetent elderly subjects. We enrolled twenty two HEV-3-infected patients displaying similar viral determinants and fifteen healthy donors. Among the infected group, sixteen patients experienced clinical symptoms related to liver disease while six remained asymptomatic. Here we report that symptomatic infection is characterized by an expansion of highly activated effector memory CD8 T (EM) cells, regardless of antigen specificity. This robust activation is associated with key features of early T cell exhaustion including a loss in polyfunctional type-1 cytokine production and partial commitment to type-2 cells. In addition, we show that bystander activation of EM cells seems to be dependent on the inflammatory cytokines IL-15 and IL-18, and is supported by an upregulation of the activating receptor NKG2D and an exuberant expression of T-Bet and T-Bet-regulated genes including granzyme B and CXCR3. We also show that the inflammatory chemokines CXCL9-10 are increased in symptomatic patients thereby fostering the recruitment of highly cytotoxic EM cells into the liver in a CXCR3-dependent manner. Finally, we find that the EM-biased immune response returns to homeostasis following viral clearance and disease resolution, further linking the EM cells response to viral burden. Conversely, asymptomatic patients are endowed with low-to-moderate EM cell response. In summary, our findings define immune correlates that contribute to HEV-3 pathogenesis and emphasize the central role of EM cells in governing the outcome of the infection.

scholarly journals Hepatitis E virus seroprevalence and associated risk factors in high-risk groups: A cross-sectional study from Turkey

2021 ◽  
Author(s):  
H. Yasemin Balaban ◽  
Abdullah Tarık Aslan ◽  
Fatma Nur Akdoğan Kittana ◽  
Alpaslan Alp ◽  
Osman Dağ ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis E Virus ◽  
Multiple Logistic Regression Analysis ◽  
Hepatitis E ◽  
Cross Sectional Study ◽  
Transplant Recipients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Independent Risk Factors ◽  
Undercooked Meat

AbstractBackgroundThe renal transplant recipients (RT), allogeneic hematopoietic stem cell transplant recipients (allo-HSCT), patients with acute hepatitis (AH), and chronic hepatitis C patients (CHC) are at risk of hepatitis E virus (HEV) infection. However, seroepidemiology, risk factors to HEV exposure, and the prevalence of HEV viremia has not yet been investigated among these patients in Turkey.Materials&MethodsIn this cross-sectional study, 292 consecutive serum samples were tested for HEV immunoglobulin IgG/IgM and HEV RNA using commercial ELISA and in-house nested PCR with Sanger sequencing, respectively. Sociodemographic, clinical, laboratory data, and risk factors were collected using a questionnaire and hospital database. Multiple logistic regression analysis was employed to identify independent predictors for anti-HEV seropositivity.ResultsAmong all patients (n=292) tested for HEV RNA reactivity, only 2 patients (one RT recipient and one patient with AH) were identified as having HEV3 viremia. HEV viremia rate was 0.6% in whole group. These patients had shown no signs of chronic HEV infection for 6 months and was found to spontaneously seroconverted 6 months after enrollment. Anti-HEV IgG was positive in 29 patients yielding an HEV seroprevalence of 9.9%. Older age (aOR:1.03, 95% CI, 1.00-1.06; p:0.022) and eating undercooked meat (aOR:3.11, 95% CI, 1.08-8.92; p:0.034) were independent risk factors to anti-HEV seropositivity in all patients. Similarly, multiple logistic regression analysis demonstrated that age (aOR:1.03, 95% CI, 0.99-1.07, p:0.058) and eating undercooked meat (aOR:5.77, 95% CI, 1.49-22.25, p:0.011) were independent risk factors for anti-HEV IgG positivity in the non-immunosuppressive subgroup consisting of AH and CHC patients.ConclusionThe HEV seroprevalence rate was high (9.9%), despite low viremia rate (0.6%) in high-risk patients. The emergence of HEV3 might indicate a serious problem for these patients. Future investigations are needed to elucidate foodborne transmission routes of HEV in Turkey.

scholarly journals Prevalence of hepatitis C virus in alcoholic patients: role of parenteral risk factors

2006 ◽  
Vol 43 (2) ◽  
pp. 81-84 ◽  
Author(s):  
Bruno Galperim ◽  
Hugo Cheinquer ◽  
Airton Stein ◽  
André Fonseca ◽  
Vagner Lunge ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Elevated Serum ◽  
Hcv Rna ◽  
Hepatitis C Virus Infection ◽  
Genotype 3 ◽  
Significant Difference

BACKGROUND: The prevalence of hepatitis C virus (HCV) infection is elevated in alcoholic patients, but the risk factors are unclear. The role of parenteral risk factors are indeterminated in this population. AIMS: To determine the prevalence of hepatitis C virus infection in alcoholic patients admitted to a detoxification unit and to evaluate the presence of underlying parenteral risk factors. METHODS: A total of 114 consecutive unselected alcoholic patients admitted to a single chemical dependency unit during 14 month were included. Epidemiological data and history of parenteral risk factors for hepatitis C virus infection were obtained with a standardized questionnaire. Blood was collected for determination of aminotransferases and anti-hepatitis C virus antibodies (ELISA-3). Positive samples were confirmed by polymerase chain reaction and tested for genotype. RESULTS: Among the 114 alcoholics, 17 (15%) were anti-hepatitis C virus positive. Of these, 12 (71%) had detectable serum HCV-RNA by PCR. Genotype 1 was found in six cases and genotype 3 in five (one patient was undetermined). Forty-nine (43%) patients had elevated serum ALT and/or AST at baseline. The comparison between the 17 positive and the 97 negative patients showed significant differences in mean serum ALT levels (42 ± 41 IU/L vs. 22 ± 20 IU/L), rate of elevated ALT (65% vs. 34%), and presence of parenteral risk factors (94% vs. 10%). Comparison between alcoholic patients with and without elevated aminotransferases showed significant difference only in the rate of positive anti-hepatitis C virus antibodies (24% vs. 7%). Furthermore, among the 17 anti-hepatitis C virus positive patients, the rate of detectable HCV-RNA was significantly higher in the 12 with elevated aminotransferases versus the 5 with normal aminotransferases (92% vs. 20%). CONCLUSIONS: There was a high prevalence of anti-hepatitis C virus antibodies in alcoholics and the majority was confirmed by the presence of detectable HCV-RNA. Intravenous drug use was the main risk factor for hepatitis C virus infection in this population.

Role of acquired and hereditary thrombotic risk factors in patients with ischemic colitis

2001 ◽  
Vol 120 (5) ◽  
pp. A282-A282
Author(s):  
I KOUTROUBAKIS ◽  
A SFIRIDAKI ◽  
A THEODOROPOULOU ◽  
A LIVADIOTAKI ◽  
P DIMOULIOS ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Colitis ◽  
Thrombotic Risk

Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Current Status ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Life Project ◽  
Resilience Factors ◽  
First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

Protective Factors and Suicidality in Members of Arab Kindred

Crisis ◽  
2012 ◽  
Vol 33 (2) ◽  
pp. 80-86 ◽  
Author(s):  
Sami Hamdan ◽  
Nadine Melhem ◽  
Israel Orbach ◽  
Ilana Farbstein ◽  
Mohammad El-Haib ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factors ◽  
Suicidal Behavior ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Suicidal Risk ◽  
Arab Population ◽  
Psychiatric Interview ◽  
History Of

Background: Relatively little is known about the role of protective factors in an Arab population in the presence of suicidal risk factors. Aims: To examine the role of protective factors in a subsample of in large Arab Kindred participants in the presence of suicidal risk factors. Methods: We assessed protective and risk factors in a sample of 64 participants (16 suicidal and 48 nonsuicidal) between 15 and 55 years of age, using a comprehensive structured psychiatric interview, the Composite International Diagnostic Interview (CIDI), self-reported depression, anxiety, hopelessness, impulsivity, hostility, and suicidal behavior in first-degree and second-relatives. We also used the Religiosity Questionnaire and suicide attitude (SUIATT) and multidimensional perceived support scale. Results: Suicidal as opposed to nonsuicidal participants were more likely to have a lifetime history of major depressive disorder (MDD) (68.8% vs. 22.9% χ2 = 11.17, p = .001), an anxiety disorder (87.5% vs. 22.9, χ2 = 21.02, p < .001), or posttraumatic stress disorder (PTSD) (25% vs. 0.0%, Fisher’s, p = .003). Individuals who are otherwise at high risk for suicidality have a much lower risk when they experience higher perceived social support (3.31 ± 1.36 vs. 4.96 ± 1.40, t = 4.10, df = 62, p < .001), and they have the view that suicide is somehow unacceptable (1.83 ± .10 vs. 1.89 ± .07, t = 2.76, df = 60, p = .008). Conclusions: Taken together with other studies, these data suggest that the augmentation of protective factors could play a very important role in the prevention of incidental and recurrent suicidal behavior in Arab populations, where suicidal behavior in increasing rapidly.

The pathway to special education: The role of early risk factors in disability identification

2014 ◽  
Author(s):  
Whitney A. Leboeuf ◽  
Benjamin Brumley ◽  
John W. Fantuzzo ◽  
Cody A. Hostutler
Keyword(s):  
Risk Factors ◽  
Special Education ◽  
Early Risk ◽  
Early Risk Factors ◽  
Disability Identification
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