title: A nationwide survey of hepatitis E viral infection in French blood donors.
abstract: Most cases of hepatitis E viral (HEV) infection in developed countries are autochthonous. Nevertheless, the reported seroprevalence of HEV varies greatly depending on the geographical area and the performance of the immunoassay used. We used validated assays to determine the prevalence of anti-HEV immunoglobulin G (IgG) and IgM among 10,569 French blood donors living in mainland France and three overseas areas. Epidemiological information was collected using a specific questionnaire. We found an overall IgG seroprevalence of 22.4% (8%-86.4%) depending on the geographical area (P < 0.001). The presence of anti-HEV IgG was associated with increasing age (P < 0.001) and eating pork meat (P = 0.03), pork liver sausages (P < 0.001), game meat (P < 0.01), offal (P < 0.001), and oysters (P = 0.02). Conversely, drinking bottled water was associated with a lower rate of anti-HEV IgG (P = 0.02). Overall IgM seroprevalence was 1% (0%-4.6%). The frequency of anti-HEV IgM was higher in donors living in a high anti-HEV IgG seroprevalence area (1.9% versus 0.7%, P < 0.001) and in those eating pork liver sausage (1.4% versus 0.7%, P < 0.01), pâté (1% versus 0.4, P = 0.04), and wild boar (1.3% versus 0.7%, P < 0.01).
  
  
  CONCLUSIONS
  HEV is endemic in France and hyperendemic in some areas; eating habits alone cannot totally explain the exposure to HEV, and contaminated water could contribute to the epidemiology of HEV infection in France.
authors.affiliation: Laboratoire de Virologie, Institut Fédératif de Biologie, Centre Hospitalier et Universitaire, Toulouse, France.
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Mansuy
authors.affiliation: Etablissement Français du Sang, La Plaine-Saint-Denis, France.|Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, UMR_D 190 "Emergence des Pathologies Virales", Institut Hospitalo Universitaire Méditerranée Infection, Marseille, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Gallian
authors.affiliation: Institut National de la Santé et de la Recherche Médicale Unité 1027, Université Toulouse III, Toulouse, France.|Unité de soutien méthodologique à la recherche, Centre Hospitalier et Universitaire, Toulouse, France.
authors.forename: Chloé
authors.initials: C
authors.lastname: Dimeglio
authors.affiliation: Laboratoire de Virologie, Institut Fédératif de Biologie, Centre Hospitalier et Universitaire, Toulouse, France.|Institut National de la Santé et de la Recherche Médicale Unité 1043, Université Toulouse III, Toulouse, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Saune
authors.affiliation: Institut National de la Santé et de la Recherche Médicale Unité 1027, Université Toulouse III, Toulouse, France.|Unité de soutien méthodologique à la recherche, Centre Hospitalier et Universitaire, Toulouse, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Arnaud
authors.affiliation: Etablissement Français du Sang, La Plaine-Saint-Denis, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Pelletier
authors.affiliation: Etablissement Français du Sang, La Plaine-Saint-Denis, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Morel
authors.affiliation: Etablissement Français du Sang, La Plaine-Saint-Denis, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Legrand
authors.affiliation: Etablissement Français du Sang, La Plaine-Saint-Denis, France.|Université de Franche-Comté, Inserm, Etablissement Français du Sang, UMR 1098, Besançon, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Tiberghien
authors.affiliation: Laboratoire de Virologie, Institut Fédératif de Biologie, Centre Hospitalier et Universitaire, Toulouse, France.|Institut National de la Santé et de la Recherche Médicale Unité 1043, Université Toulouse III, Toulouse, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Izopet
mesh_terms: D000328:Adult; D001782:Blood Donors; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious / Q000706:statistics & numerical data*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005602:France / Q000453:epidemiology; D006508:Hepatitis Antibodies / Q000097:blood*; D016751:Hepatitis E / Q000453:epidemiology* / Q000209:etiology; D016752:Hepatitis E virus / Q000302:isolation & purification; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D016036:Seroepidemiologic Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G