title: Hepatitis E virus and hepatitis A virus exposures in an apparently healthy high-risk population in Italy.
abstract: OBJECTIVE
  The prevalence of anti-hepatitis E virus (HEV) and anti-hepatitis A virus (HAV), as well as the possible links with socio-demographic and other viral risks factors, were evaluated in an inmates population.
  
  
  METHODS
  The study population consisted of 973 consecutively recruited inmates of eight Italian prisons.
  
  
  RESULTS
  The anti-HEV prevalence was 11.6 % (113/973). It increased significantly by age (χ(2) for linear trend: p = 0.001) and was significantly higher among non-Italian compared to Italian inmates (15.3 vs. 10.7 %, respectively). Age >40 years [odds ratio (OR) 2.1; 95 % confidence interval (CI) 1.4-3.1], non-Italian citizenship (OR 1.8; 95 % CI 1.1-2.9) and anti-HIV seropositivity (OR 2.2; 95 % CI 1.2-4.2) were the only factors independently associated to anti-HEV positivity by logistic regression analysis. The overall anti-HAV prevalence was 86.4 %, and was significantly higher in non-Italian compared to Italian prisoners (92.6 vs. 84.9 %, respectively; p = 0.02). Age older than 40 years (OR 3.6; 95 % CI 2.2-5.9), <5 years formal education (OR 2.1; 95 % CI 1.3-3.2) and non-Italian nationality (OR 2.7; 95 % CI 1.5-4.8) were factors independently associated to anti-HAV positivity by the logistic regression analysis.
  
  
  CONCLUSIONS
  Compared to the general population, significantly higher anti-HEV and anti-HAV prevalences were observed in an inmates population in Italy. Old age and non-Italian nationality were factors independently related to both HEV and HAV exposures. This data suggest the important role of low socio-economic factors in the transmission of both infections in high-risk populations. The possible epidemiological and/or pathogenetic links between HEV and HIV exposures need to be studied further.
authors.affiliation: Viral Hepatitis Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena, 299-00161, Rome, Italy. maria.rapicetta@iss.it
authors.forename: M
authors.initials: M
authors.lastname: Rapicetta
authors.forename: R
authors.initials: R
authors.lastname: Monarca
authors.forename: L A
authors.initials: LA
authors.lastname: Kondili
authors.forename: P
authors.initials: P
authors.lastname: Chionne
authors.forename: E
authors.initials: E
authors.lastname: Madonna
authors.forename: G
authors.initials: G
authors.lastname: Madeddu
authors.forename: A
authors.initials: A
authors.lastname: Soddu
authors.forename: A
authors.initials: A
authors.lastname: Candido
authors.forename: S
authors.initials: S
authors.lastname: Carbonara
authors.forename: M S
authors.initials: MS
authors.lastname: Mura
authors.forename: G
authors.initials: G
authors.lastname: Starnini
authors.forename: S
authors.initials: S
authors.lastname: Babudieri
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology*; D030041:Hepatitis A virus / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000097:blood / Q000276:immunology; D016751:Hepatitis E / Q000453:epidemiology*; D016752:Hepatitis E virus / Q000276:immunology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D006508:Hepatitis Antibodies