title: Seroepidemiology of HEV and HAV in two populations with different socio-economic levels and hygienic/sanitary conditions.
abstract: The epidemiological scenarios of hepatitis E virus (HEV) and hepatitis A virus (HAV) infections have changed in the last few decades, but precise epidemiological data on the prevalence of anti-HEV and anti-HAV, alone or in combination, in the general population are scanty. We investigated HEV and HAV seroprevalence comparing two population samples living in Northern (Abbiategrasso, Milan) and Southern Italy (Cittanova, Reggio Calabria), the latter being characterized by a poorer socio-economic level and hygienic/sanitary conditions. Based on census records, we randomly enrolled and tested 3,365 subjects (Abbiategrasso, n = 2,489; Cittanova, n = 876) aged 18-75 years for anti-HAV and anti-HEV. Anti-HAV (71.3 % vs 52.5 %) and anti-HEV (17.8 % vs 9.0 %) prevalence rates were higher in Southern Italy (both p < 0.001). Most anti-HEV-positive subjects also had anti-HAV. Subjects testing positive for anti-HAV, alone or with anti-HEV, were older (p < 0.001 in both populations) and showed a trend toward declining prevalence in the youngest birth cohorts. The prevalence of subjects with a positive result for anti-HEV alone did not change in birth cohorts in the two towns. Detection of anti-HEV was independently associated with anti-HAV, town, birth cohort, and education level in multivariate analysis. Low socio-economic level and hygienic/sanitary conditions are associated with high HAV and HEV seroprevalence rates in Italy. Recent improvements, especially in the South, have led to a declining prevalence of anti-HAV, alone or with anti-HEV. Seroprevalence of HEV alone is uniformly low and does not change in birth cohorts born between 1938 and 1993.
authors: Division of Internal Medicine and Liver Unit, Department of Health Sciences, School of Medicine Ospedale San Paolo, Università degli Studi di Milano, via di Rudinì, 8, 20143, Milan, Italy.
authors: M
authors: M
authors: Zuin
authors: Calabria Association of Hepatology, Reggio Calabria, Italy.
authors: C
authors: C
authors: Caserta
authors: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.
authors: L
authors: L
authors: Romanò
authors: Calabria Association of Hepatology, Reggio Calabria, Italy.
authors: A
authors: A
authors: Mele
authors: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.
authors: A
authors: A
authors: Zanetti
authors: Division of Internal Medicine and Liver Unit, Department of Health Sciences, School of Medicine Ospedale San Paolo, Università degli Studi di Milano, via di Rudinì, 8, 20143, Milan, Italy.
authors: R
authors: R
authors: Cannatelli
authors: Azienda Socio-sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy.
authors: A
authors: A
authors: Giorgini
authors: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.
authors: C
authors: C
authors: Tagliacarne
authors: Calabria Association of Hepatology, Reggio Calabria, Italy.
authors: A
authors: A
authors: Amante
authors: Calabria Association of Hepatology, Reggio Calabria, Italy.|Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy.
authors: F
authors: F
authors: Marcucci
authors: Division of Internal Medicine and Liver Unit, Department of Health Sciences, School of Medicine Ospedale San Paolo, Università degli Studi di Milano, via di Rudinì, 8, 20143, Milan, Italy. piermaria.battezzati@unimi.it.
authors: P M
authors: http://orcid.org/0000-0003-1344-3452
authors: PM
authors: Battezzati
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology*; D030041:Hepatitis A virus / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000097:blood*; D016751:Hepatitis E / Q000453:epidemiology*; D016752:Hepatitis E virus / Q000276:immunology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D006508:Hepatitis Antibodies