title: Seroepidemiology of Hepatitis E in Selected Population Groups in Croatia: A Prospective Pilot Study.
abstract: Hepatitis E has become an emerging infection in many European countries. We analysed the prevalence of hepatitis E virus (HEV) infection in selected population groups in Croatia. Overall HEV IgG seropositivity was 5.6%, while 1.9% participants showed IgM antibodies suggestive of recent infection. No IgM-positive sample was positive for HEV RNA. HEV IgG antibodies were most prevalent in alcohol abusers (8.9%) and war veterans (8.6%), compared with 6.1% among injecting drug users and 2.7% in healthcare professionals. No individual with high-risk sexual behaviour tested HEV seropositive. HEV IgG positivity increased significantly with age from 1.8% to 2.3% in individuals younger than 40 years to 11.3% in individuals older than 50 years (P = 0.023). The mean age of HEV-positive participants was significantly higher than that of HEV-negative participants (50.9 ± 11.8 years versus 41.2 ± 11.8 years, P = 0.008). Seroprevalence rates were significantly higher in residents of suburban and rural areas compared with residents of urban areas (14.5% versus 2.5%, P = 0.003). Additionally, an increasing prevalence of HEV IgG antibodies was observed from 1.8% in participants living in families with two household members to 12.1% in those living with more than four members (P = 0.046). Gender, marital status, educational level, sexual orientation, source of drinking water, history of blood transfusions, surgical procedures, tattooing and travelling were not associated with HEV seroprevalence. Logistic regression showed that living in suburban/rural areas was the main risk factor for HEV seropositivity (OR = 6.67; 95%CI = 1.89-25.0; AOR = 7.14, 95%CI = 1.89-25.0).
authors.affiliation: Department of Virology, Croatian National Institute of Public Health, Zagreb, Croatia.|School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: T
authors.initials: T
authors.lastname: Vilibic-Cavlek
authors.affiliation: Vrapce University Psychiatric Hospital, Zagreb, Croatia.
authors.forename: M
authors.initials: M
authors.lastname: Vilibic
authors.affiliation: Department of Epidemiology, Teaching Institute 'Dr Andrija Stampar', Zagreb, Croatia.|School of Medicine, University of Rijeka, Rijeka, Croatia.
authors.forename: B
authors.initials: B
authors.lastname: Kolaric
authors.affiliation: Department of Virology, Croatian Veterinary Institute, Zagreb, Croatia.
authors.forename: L
authors.initials: L
authors.lastname: Jemersic
authors.affiliation: Department of Microbiology, Istria County Institute of Public Health, Pula, Croatia.
authors.forename: J
authors.initials: J
authors.lastname: Kucinar
authors.affiliation: Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: L
authors.initials: L
authors.lastname: Barbic
authors.affiliation: Vrapce University Psychiatric Hospital, Zagreb, Croatia.
authors.forename: A
authors.initials: A
authors.lastname: Bagaric
authors.affiliation: Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: V
authors.initials: V
authors.lastname: Stevanovic
authors.affiliation: Department of Virology, Croatian National Institute of Public Health, Zagreb, Croatia.
authors.forename: I
authors.initials: I
authors.lastname: Tabain
authors.affiliation: School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: M
authors.initials: M
authors.lastname: Sviben
authors.affiliation: School of Medicine, University of Zagreb, Zagreb, Croatia.|Vrapce University Psychiatric Hospital, Zagreb, Croatia.
authors.forename: V
authors.initials: V
authors.lastname: Jukic
authors.affiliation: Department of Virology, Croatian National Institute of Public Health, Zagreb, Croatia.|School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: G
authors.initials: G
authors.lastname: Mlinaric-Galinovic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral; D017523:Croatia / Q000453:epidemiology; D005260:Female; D016751:Hepatitis E / Q000097:blood / Q000453:epidemiology*; D016752:Hepatitis E virus / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G
keywords: Croatia; Hepatitis E; prevalence; risk factors