Epidemiology of hepatitis E virus infection in EU/EEA countries
Hepatitis E virus (HEV) is considered to be one of the most common causes of acute hepatitis worldwide. Over the last decades, increased numbers of new HEV infections acquired across European Union (EU)/European Economic Area (EEA) were reported, indicating HEV infections are more common than formerly expected in high-income countries. For quantifying the epidemiological situation of HEV infection across EU/EEA, epidemiological information on HEV seroprevalence as measured by antibodies against HEV (anti-HEV IgG) is crucial. However, since HEV infection is not under EU-wide surveillance, no harmonized case definition and notification procedures across countries exists. Previous reviews on HEV were restricted to certain factors, e.g. geographical region or to a single HEV infection marker and were not based on systematic searches.
The aim of this project was to systematically identify, assess and analyze available data on HEV epidemiology in EU/EEA. In cooperation with the European Centre for Disease Prevention and Control (ECDC) data inclusion criteria were developed and all relevant and available data on the HEV infection markers anti-HEV IgG, anti-HEV IgM, and HEV-RNA as well as variables which might affect the HEV positivity were systematically screened and extracted. Meta-analytic approaches were developed and applied to generate country-specific estimates for each HEV infection marker and accounted for relevant HEV-associated variables. Specific influences of identified variables significantly affecting the variance of HEV positivity, like applied commercial assays and population group studied, are assessed and their impact on the geographical distribution of HEV endemicity level across EU/EEA is discussed.
Cooperation and funding
- European Centre for Disease Prevention and Control (ECDC)
- HZI - Helmholtz Centre for Infection Research
- Epidemiologie - Prof. Dr. Gérard Krause