Article Text


Viral hepatitis
P79 Hepatitis E virus is highly endemic in South West France
  1. H Dalton,
  2. J M Mansuy,
  3. R Bendall,
  4. F Legrand-Abravanel,
  5. J P Calot,
  6. N Kamar,
  7. M Miedouge,
  8. V Ellis,
  9. H Rech,
  10. F Destruel,
  11. H R Dalton,
  12. J Izopet
  1. Peninsula College of Medicine and Dentistry, Royal Cornwall Hospital, UK


Introduction Locally acquired hepatitis E virus (HEV) infection is an emerging infection in developed countries. South West France has a high incidence of HEV and has reported a large number of chronic cases of HEV infection. We previously estimated the HEV seroprevalence in blood donors in Midi-Pyrénées to be 16.6%, very much higher than the rate seen in Northern France (3.2%). However, comparison between seroprevalence studies is difficult. There is no gold-standard for measuring HEV antibodies and commercial assays vary in performance. A recent study has suggested poor sensitivity in a commonly used HEV IgG assay, which underestimates seroprevalence by a factor of 4.51. Since this assay was used in our previous study of HEV seroprevalence in Midi-Pyrénées, we repeated the study using a more sensitive assay previously validated against sera from cases of HEV genotype 3 infection.

Aim To re-examine the seroprevalence of anti-HEV IgG using a sensitive, validated assay.

Method Sera from 512 blood donors (aged 18–65 yrs) and 50 children (aged 2–4 yrs) were tested for anti-HEV IgG (Wantai, Beijing, China). Demographic data and putative risk factors for HEV acquisition were collected using a structured questionnaire.

Results The HEV seroprevalence in blood donors was 52.5%. 63.1% of donors from rural areas and 42.9% of donors from urban ones were positive for anti-HEV IgG (p<0.01). The HEV seroprevalence increased gradually with the age from 32.8% in donors aged 18–27 years to 70% in donors aged 58–65 years (p<0.01). The prevalence of anti-HEV in men (51.4%) and women (54.7%) was similar. In children aged 2–4 years the HEV seroprevalence was 2%, suggesting that the high seroprevalence seen in the blood donors was not due to cross-reacting antibodies. Multivariate analysis identified age, rural residence, contact with cats and hunting as the factors independently associated with anti-HEV IgG positivity.

Conclusion HEV is highly endemic in South West France, and the seroprevalence approaches that found in many developing countries where HEV is endemic. Seroepidemiological studies of hepatitis E which use less sensitive assays may not produce a valid assessment of the relevant risk factors.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.