학술논문
Annual risk of hepatitis E virus infection and seroreversion: Insights from a serological cohort in Sitakunda, Bangladesh.
Document Type
Academic Journal
Author
Dighe A; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Khan AI; Infectious Disease Division, icddr, b, Dhaka, Bangladesh.; Bhuiyan TR; Infectious Disease Division, icddr, b, Dhaka, Bangladesh.; Islam MT; Infectious Disease Division, icddr, b, Dhaka, Bangladesh.; Khan ZH; Infectious Disease Division, icddr, b, Dhaka, Bangladesh.; Khan II; Infectious Disease Division, icddr, b, Dhaka, Bangladesh.; Hulse JD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Ahmed S; Bangladesh Institute of Tropical and Infectious Diseases, Chattogram, Bangladesh.; Rashid M; Bangladesh Institute of Tropical and Infectious Diseases, Chattogram, Bangladesh.; Hossain MZ; Bangladesh Institute of Tropical and Infectious Diseases, Chattogram, Bangladesh.; Rashid R; Bangladesh Institute of Tropical and Infectious Diseases, Chattogram, Bangladesh.; Hegde ST; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Gurley ES; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Qadri F; Infectious Disease Division, icddr, b, Dhaka, Bangladesh.; Azman AS; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland.; Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland.
Source
Publisher: Cambridge University Press Country of Publication: England NLM ID: 8703737 Publication Model: Electronic Cited Medium: Internet ISSN: 1469-4409 (Electronic) Linking ISSN: 09502688 NLM ISO Abbreviation: Epidemiol Infect Subsets: MEDLINE
Subject
Language
English
Abstract
Hepatitis E virus (HEV) is a major cause of acute jaundice in South Asia. Gaps in our understanding of transmission are driven by non-specific symptoms and scarcity of diagnostics, impeding rational control strategies. In this context, serological data can provide important proxy measures of infection. We enrolled a population-representative serological cohort of 2,337 individuals in Sitakunda, Bangladesh. We estimated the annual risks of HEV infection and seroreversion both using serostatus changes between paired serum samples collected 9 months apart, and by fitting catalytic models to the age-stratified cross-sectional seroprevalence. At baseline, 15% (95 CI: 14-17%) of people were seropositive, with seroprevalence highest in the relatively urban south. During the study, 27 individuals seroreverted (annual seroreversion risk: 15%, 95 CI: 10-21%), and 38 seroconverted (annual infection risk: 3%, 95CI: 2-5%). Relying on cross-sectional seroprevalence data alone, and ignoring seroreversion, underestimated the annual infection risk five-fold (0.6%, 95 CrI: 0.5-0.6%). When we accounted for the observed seroreversion in a reversible catalytic model, infection risk was more consistent with measured seroincidence. Our results quantify HEV infection risk in Sitakunda and highlight the importance of accounting for seroreversion when estimating infection incidence from cross-sectional seroprevalence data.