Epidemiology of hepatitis E virus in the United States

Results from the third national health and nutrition examination survey, 1988-1994

Mark H. Kuniholm, Robert H. Pureell, Geraldine M. McQuillan, Ronald E. Engle, Annemarie Wasley, Kenrad Edwin Nelson

Research output: Contribution to journalArticle

Abstract

Background. Hepatitis E virus (HEV) is prevalent and causes disease worldwide, but its epidemiological profile is only partially understood. Methods. We used an enzyme immunoassay to measure anti-HEV immunoglobulin G antibodies in 18,695 serum samples collected in the Third National Health and Nutrition Examination Survey. We calculated estimates of HEV seroprevalence and examined associations with putative risk factors. Results. The seroprevalence of HEV in the civilian noninstitutionalized United States (US) population during the period from 1988 through 1994 was 21.0% (95% confidence interval [CI], 19.0%-22.9%). Among US-born individuals, males, non-Hispanic whites, and individuals residing in the Midwest and/or in metropolitan areas had the highest seroprevalence estimates. Having a pet in the home (odds ratio [OR], 1.19 [95% CI, 1.01-1.40]) and consuming liver or other organ meats more than once per month (OR, 1.38 [95% CI, 1.01-1.88]) were significantly associated with increased odds of HEV seropositivity. Conclusions. Exposure to HEV is common in the US population, although hepatitis E is rarely reported. Having pets and consuming organ meats may play a role in HEV transmission in the United States, but other mechanisms of transmission may also exist. HEV may be considered a possible etiologic agent of acute and chronic hepatitis in US patients reporting no travel history.

Original languageEnglish (US)
Pages (from-to)48-56
Number of pages9
JournalJournal of Infectious Diseases
Volume200
Issue number1
DOIs
StatePublished - Jul 1 2009

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Hepatitis E virus
Nutrition Surveys
Epidemiology
Seroepidemiologic Studies
Pets
Confidence Intervals
Meat
Odds Ratio
Hepatitis E
Chronic Hepatitis
Immunoenzyme Techniques
Immunoglobulin E
Population
Immunoglobulin G
Antibodies
Liver

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy

Cite this

Epidemiology of hepatitis E virus in the United States : Results from the third national health and nutrition examination survey, 1988-1994. / Kuniholm, Mark H.; Pureell, Robert H.; McQuillan, Geraldine M.; Engle, Ronald E.; Wasley, Annemarie; Nelson, Kenrad Edwin.

In: Journal of Infectious Diseases, Vol. 200, No. 1, 01.07.2009, p. 48-56.

Research output: Contribution to journalArticle

Kuniholm, Mark H. ; Pureell, Robert H. ; McQuillan, Geraldine M. ; Engle, Ronald E. ; Wasley, Annemarie ; Nelson, Kenrad Edwin. / Epidemiology of hepatitis E virus in the United States : Results from the third national health and nutrition examination survey, 1988-1994. In: Journal of Infectious Diseases. 2009 ; Vol. 200, No. 1. pp. 48-56.
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