Seroprevalence of Hepatitis E Virus Varies Considerably Among Chinese Provinces

BACKGROUND: Hepatitis E is a common infection in China, but few studies have been carried out to compare regional and ethnic factors in its prevalence. OBJECTIVES: To characterize the seroprevalence of anti-HEV IgM and IgG in the general population of 11 Chinese provinces and in the people from different ethnic minorities. MATERIALS AND METHODS: Sera from 14208 people including 723 people from four ethnic minorities were screened for anti-HEV IgM and IgG by enzyme-linked immunosorbent assay (ELISA). For the anti-HEV IgM positive samples, reverse transcription-polymerase chain reaction (RT-PCR) was carried out for the detection of HEV RNA. RESULTS: The overall prevalence of anti-HEV IgG was 19.7%. The highest rate was 35.7% in Guizhou, while the lowest rate was 5.5% in Shanxi. Significantly higher rates were found among males compared to females in Hebei and Hunan province, and among females compared to males in Chongqing and Shannxi. In Guizhou, the prevalence rates among the Buyi, Miao, Shui and Han ethnic groups were 41.8%, 32.0%, 37.5% and 34.7%, respectively, which were not significantly different. The results also showed that the anti-HEV IgG detection rates increased with age for each ethnic group. Additionally, four samples were tested positive for anti-HEV IgM but HEV RNA was not detectable. CONCLUSIONS: HEV prevalence varies considerably among Chinese provinces. Thus, prevention and control programs including vaccination could be specifically targeted to people living in regions with relatively higher prevalences.