title: Bayesian estimation of hepatitis E virus seroprevalence for populations with different exposure levels to swine in The Netherlands.
abstract: Hepatitis E virus (HEV) is ubiquitous in pigs worldwide and may be zoonotic. Previous HEV seroprevalence estimates for groups of people working with swine were higher than for control groups. However, discordance among results of anti-HEV assays means that true seroprevalence estimates, i.e. seroprevalence due to previous exposure to HEV, depends on choice of seroassay. We tested blood samples from three subpopulations (49 swine veterinarians, 153 non-swine veterinarians and 644 randomly selected individuals from the general population) with one IgM and two IgG ELISAs, and subsets with IgG and/or IgM Western blots. A Bayesian stochastical model was used to combine results of all assays. The model accounted for imperfection of each assay by estimating sensitivity and specificity, and accounted for dependence between serological assays. As expected, discordance among assay results occurred. Applying the model yielded seroprevalence estimates of approximately 11% for swine veterinarians,approximately 6% for non-swine veterinarians and approximately 2% for the general population. By combining the results of five serological assays in a Bayesian stochastical model we confirmed that exposure to swine or their environment was associated with elevated HEV seroprevalence.
authors.affiliation: Laboratory for Zoonoses and Environmental Microbiology, Centre for Infectious Disease Control Netherlands, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. martijn.bouwknegt@rivm.nl
authors.forename: M
authors.initials: M
authors.lastname: Bouwknegt
authors.forename: B
authors.initials: B
authors.lastname: Engel
authors.forename: M M P T
authors.initials: MM
authors.lastname: Herremans
authors.forename: M A
authors.initials: MA
authors.lastname: Widdowson
authors.forename: H C
authors.initials: HC
authors.lastname: Worm
authors.forename: M P G
authors.initials: MP
authors.lastname: Koopmans
authors.forename: K
authors.initials: K
authors.lastname: Frankena
authors.forename: A M
authors.initials: AM
authors.lastname: de Roda Husman
authors.forename: M C M
authors.initials: MC
authors.lastname: De Jong
authors.forename: W H M
authors.initials: WH
authors.lastname: Van Der Poel
mesh_terms: D000328:Adult; D000818:Animals; D001499:Bayes Theorem; D005260:Female; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control / Q000635:transmission*; D016752:Hepatitis E virus / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D013552:Swine; D018634:Veterinarians / Q000706:statistics & numerical data; D015047:Zoonoses
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M