title: Seroprevalence and anti-HEV persistence in the general population of the Republic of San Marino.
abstract: The prevalence of anti-HEV was assessed in 2,233 subjects aged 20-79 years in the Republic of San Marino in the years 1990-1991. The sera were tested by ELISA and further confirmed by Western blot (WB) analysis. The overall anti-HEV prevalence was 1.5%. A significant trend by age was observed. Anti-HEV prevalence was 0.6% in subjects <30 years and 3.3% in those older than 70 years of age. Family size larger than four persons (OR = 3.8; 95% CI = 1.8-13.2) was the sole independent predictor of anti-HEV positivity in the multivariate analysis. Anti-HAV and anti-HEV prevalences did not show a parallel trend by age. No association was found either between hepatitis E virus (HEV) or hepatitis C virus (HCV) infections. Follow-up samples 5 years apart were available for 38 out of 54 (70%) anti-HEV ELISA-positive subjects. Eight out of 22 (37%) WB-confirmed anti-HEV-positive subjects were still anti-HEV-positive after 5 years. However, anti-HEV remained positive in all but two (75%) of the subjects with WB-confirmed ELISA positivity value of S/CO > or = 2 (cutoff 1.2), but in only 2 out of the 14 subjects (14%) with a WB-confirmed ELISA positivity value of S/CO < 2 (P < 0.005). None of the 16 subjects ELISA-positive but not WB-confirmed was anti-HEV-positive 5 years apart. Therefore, only a relative proportion of subjects once infected with HEV maintain for at least 5 years anti-HEV antibodies.
authors.affiliation: Laboratory of Virology, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rapicetta
authors.forename: L A
authors.initials: LA
authors.lastname: Kondili
authors.forename: S
authors.initials: S
authors.lastname: Pretolani
authors.forename: T
authors.initials: T
authors.lastname: Stroffolini
authors.forename: P
authors.initials: P
authors.lastname: Chionne
authors.forename: U
authors.initials: U
authors.lastname: Villano
authors.forename: E
authors.initials: E
authors.lastname: Madonna
authors.forename: F
authors.initials: F
authors.lastname: Casali
authors.forename: G
authors.initials: G
authors.lastname: Gasbarrini
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D016751:Hepatitis E / Q000097:blood / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D016752:Hepatitis E virus / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012496:San Marino / Q000453:epidemiology