title: Unexpected elevated alanine aminotransferase, aspartate aminotransferase levels and hepatitis E virus infection among persons who work with pigs in accra, Ghana.
abstract: BACKGROUND
  Several studies have suggested that elevated serum alanine aminotransferase (ALT) and asparte aminotransferase (AST) may be markers of hepatitis E virus (HEV) infection. Thus, individuals with elevated ALT and AST may have ongoing subclinical infection of HEV. We estimated the prevalence of anti-HEV antibodies and serum ALT and AST levels among persons who work with pigs in Accra, Ghana.
  
  
  RESULTS
  Three hundred and fifty- persons who work with pigs provided blood samples for unlinked anonymous testing for the presence of antibodies to HEV, ALT and AST levels. The median age of participants was 32.85±11.38 years (range 15-70 years). HEV seroprevelance was 34.84%. Anti-HEV IgG was detected in 19.26% while anti-HEV IgM was detected in 15.58% of the persons who tested positive. On multivariate analysis, the independent determinants of HEV infection were, being employed on the farm for less than six months [odds ratio (OR) 8.96; 95% confidence interval (95% CI) 5.43-14.80], having piped water in the household and/or on the farm (OR 13.33; 95% CI 5.23-33.93) and consumption of alcohol (OR 4.91: 95% CI 2.65-9.10). Levels>3× the expected maximum were found for both ALT and AST among individuals who tested positive for anti-HEV IgG (ALT, 210.17±11.64 U/L; AST, 127.18±11.12 U/L) and anti-HEV IgM (ALT, 200.97±10.76 U/L; AST, 120.00±15.96 U/L).
  
  
  CONCLUSIONS
  Consistent with similar studies worldwide, the results of our studies revealed a high prevalence of HEV infection, ALT and AST values in pig handlers.
authors.affiliation: Department of Pathology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana. andrewanthonyadjei@yahoo.com
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Adjei
authors.forename: Yao
authors.initials: Y
authors.lastname: Tettey
authors.forename: John T
authors.initials: JT
authors.lastname: Aviyase
authors.forename: Clement
authors.initials: C
authors.lastname: Adu-Gyamfi
authors.forename: Julius A
authors.initials: JA
authors.lastname: Mingle
authors.forename: Edmund T
authors.initials: ET
authors.lastname: Nartey
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000383:Agriculture; D000410:Alanine Transaminase / Q000097:blood*; D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood*; D005869:Ghana / Q000453:epidemiology; D006508:Hepatitis Antibodies / Q000097:blood*; D016751:Hepatitis E / Q000453:epidemiology* / Q000473:pathology; D016752:Hepatitis E virus / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D016036:Seroepidemiologic Studies; D013552:Swine; D055815:Young Adult
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase