Insights into hepatitis E virus epidemiology in Croatia

BACKGROUND Hepatitis E virus(HEV)is an emerging virus of global health concern.The seroprevalence rates differ greatly according to geographic region and population group.AIM To analyze the seroprevalence of HEV in exposed(animal-related professions)and nonexposed populations,as well as solid organ and hematopoietic stem cell transplant patients.METHODS Forestry workers(n=93),hunters(n=74),and veterinarians(n=151)represented the exposed population.The general population(n=126)and pregnant women(n=118)constituted the control group.Transplant patients included liver transplant recipients(LTRs)(n=83),kidney transplant recipients(KTRs)(n=43),and hematopoietic stem cell transplant recipients(HSCRs)(n=39).HEV immunoglobulin G antibodies were detected using the enzyme-linked immunosorbent assay and confirmed by the immunoblot test.RESULTS The HEV seroprevalence significantly differed between groups:Veterinarians 15.2%,hunters 14.9%,forestry workers 6.5%,general population 7.1%,and pregnant women 1.7%.In transplant patients,the seropositivity was highest in LTRs(19.3%),while in KTRs and HSCRs,the seroprevalence was similar to the general population(6.9%and 5.1%,respectively).A significant increase in seropositivity with age was observed from 2.9%in individuals less than 30 years to 23.5%in those older than 60 years.Sociodemographic characteristics(sex,educational level,area of residence,and number of household members),eating habits(game meat,offal,and pork products consumption),and environmental and housing conditions(drinking water supply,type of water drainage/sewer,waste disposal,domestic animals)were not associated with HEV seropositivity.However,individuals who reported a pet ownership were more often seropositive compared to those who did not have pet animals(12.5%vs 7.0%).CONCLUSION The results of this study showed that individuals in professional contact with animals and LTRs are at higher risk for HEV infection.In addition,age is a significant risk factor for HEV seropositivity.

Parvovirus B19 status in liver,kidney and pancreas transplant candidates:A single center experience

BACKGROUND Parvovirus B19(B19V)is associated with a wide range of clinical manifestations.The major presentation is erythema infectiosum.However,a persistent infection may cause pure red cell aplasia and chronic anemia in immunocompromized patients.The B19V seroprevalence varies with age and geographical location.AIM To determine the B19V serological status and DNAemia in kidney,liver,and pancreas transplant candidates.METHODS Patients who underwent kidney,liver,or simultaneous kidney and pancreas/liver transplantation between January 2021 and May 2022 were included in the study.The serum samples were collected before transplantation.For detection of B19V DNA,a LightMix Kit B19V EC(TIB MOLBIOL,Berlin,Germany)was used.B19V IgM and IgG antibodies were detected using a commercial ELISA test(Euroimmun,Lübeck,Germany).RESULTS One hundred and thirty-one transplant candidates were included in the study,71.0%male,with an average age of 53.27 years±12.71 years.There were 68.7%liver,27.5%kidney,3.0%simultaneous pancreas/kidney transplant(SPKT),and 0.8%simultaneous liver/kidney transplant recipients.No patients had detectable B19V DNA.B19V IgG seroprevalence was 77.1%.No acute or recent infections were detected(IgM antibodies).There was no difference in the mean age of seronegative and seropositive patients(51.8 years±12.9 years vs 53.7 years±12.7 years,t=-0.603;P=0.548).Although seropositivity was lower in patients aged less than 30 years(66.6%)compared to the patients aged 30-59 years and>60 years(80.4%and 78.1%,respectively),this difference was not significant.In addition,there was no difference in seropositivity between male and female transplant candidates,76.3%and 78.9%(χ^(2)=0.104;P=0.748).The seroprevalence did not differ among organ recipients,with 77.8%,80.6%,and 50.0%for liver,kidney,and SPKT,respectively,(χ^(2)=5.297;P=0.151).No significant difference was found in the seroprevalence in kidney transplant patients according to dialysis modality.Seroprevalence was 71.1%in hemodialysis patients,and 100%in peritoneal dialysis patients(χ^(2)=0.799;P=0.372).CONCLUSION The B19V seroprevalence is expectedly high among kidney,liver,and pancreas transplant candidates,but there are still 22.9%of seronegative individuals who remain at risk for primary disease and severe manifestations.Further research should elucidate the necessity of B19V screening in peri-transplant management.