Age and Gender Trends in the Prevalence of Markers for Hepatitis E Virus Exposure in the Heterogeneous Bulgarian Population
Elitsa Golkocheva-Markova,
Chiydem Ismailova,
Ani Kevorkyan,
Ralitsa Raycheva,
Sashka Zhelyazkova,
Stanislav Kotsev,
Maria Pishmisheva,
Vanya Rangelova,
Asya Stoyanova,
Viliana Yoncheva,
Tencho Tenev,
Teodora Gladnishka,
Iva Trifonova,
Iva Christova,
Roumen Dimitrov,
Roberto Bruni,
Anna Rita Ciccaglione
Affiliations
Elitsa Golkocheva-Markova
NRL Hepatitis Viruses, Department of Virology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria
Chiydem Ismailova
NRL Hepatitis Viruses, Department of Virology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria
Ani Kevorkyan
Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University, 4002 Plovdiv, Bulgaria
Ralitsa Raycheva
Department of Social Medicine and Public Health, Faculty of Public Health, Medical University, 4002 Plovdiv, Bulgaria
Sashka Zhelyazkova
Clinic of Nervous Diseases, University Hospital “Alexandrovska”, Medical University, 1431 Sofia, Bulgaria
Stanislav Kotsev
Department Infectious Diseases, Regional Hospital, 4400 Pazardzhik, Bulgaria
Maria Pishmisheva
Department Infectious Diseases, Regional Hospital, 4400 Pazardzhik, Bulgaria
Vanya Rangelova
Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University, 4002 Plovdiv, Bulgaria
Asya Stoyanova
NRL Enteroviruses, Department of Virology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria
Viliana Yoncheva
NRL Hepatitis Viruses, Department of Virology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria
Tencho Tenev
NRL Hepatitis Viruses, Department of Virology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria
Teodora Gladnishka
NRL of Vector-Borne Infections, Listeria and Leptospires, Department of Microbiology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria
Iva Trifonova
NRL of Vector-Borne Infections, Listeria and Leptospires, Department of Microbiology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria
Iva Christova
NRL of Vector-Borne Infections, Listeria and Leptospires, Department of Microbiology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria
Roumen Dimitrov
Institute of Mathematics and Informatics, Bulgarian Academy of Sciences, 1000 Sofia, Bulgaria
Roberto Bruni
Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
Anna Rita Ciccaglione
Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
The prevalence of hepatitis E virus (HEV) in the Bulgarian population remains underestimated. The aim of the present study was to evaluate age and gender trends in HEV prevalence in the heterogeneous Bulgarian population. Stored serum samples from blood donors and different patient sub-populations—kidney recipients (KR), patients with Guillain–Barre syndrome (GBS), Lyme disease (LD), patients with liver involvement and a clinical diagnosis other than viral hepatitis A and E (non-AE), hemodialysis (HD) and HIV-positive patients (HIV)—were retrospectively investigated for markers of past and recent/ongoing HEV infection. The estimated overall seroprevalence of past infection was 10.6%, ranging from 5.9% to 24.5% for the sub-populations evaluated, while the seroprevalence of recent/ongoing HEV infection was 7.5%, ranging from 2.1% to 20.4%. The analysis of the individual sub-populations showed a different prevalence with respect to sex. In regard to age, the cohort effect was preserved, as a multimodal pattern was observed only for the GBS sub-population. Molecular analysis revealed HEV 3f and 3e. The type of the population is one of the main factors on which the anti-HEV prevalence depends, highlighting the need for the development of guidelines related to the detection and diagnosis of HEV infection with regard to specific patient populations.
