Prevalence of Hepatitis E Virus Antibodies, Israel, 2009–2010

Orna Mor, Ravit Bassal, Michal Michaeli, Marina Wax, Daniela Ram, Oranit Cohen-Ezra, Dani Cohen, Ella Mendelson, Ziv Ben-Ari, and Tamy Shohat

Author affiliations: Central Virology Laboratory, Ministry of Health, Ramat-Gan, Israel (O. Mor, M. Michaeli, M. Wax, D. Ram, E. Mendelson); Israel Center for Disease Control, Ministry of Health, Ramat-Gan (R. Bassal, T. Shohat); Sheba Medical Center, Ramat-Gan (O. Cohen-Ezra, Z. Ben-Ari); Tel-Aviv University, Tel-Aviv, Israel (D. Cohen, E. Mendelson, T. Shohat)

Abstract

We investigated prevalence of hepatitis E virus in a sample of the population of Israel. The overall seroprevalence of antibodies to the virus was 10.6% (95% CI 8.4%–13.0%); age-adjusted prevalence was 7.6%. Seropositivity was associated with age, Arab ethnicity, low socioeconomic status, and birth in Africa, Asia, or the former Soviet Union.

Acute viral hepatitis is caused by hepatitis E virus (HEV), which can be divided into 4 genotypes (1–4). Genotype 1, transmitted mainly through the fecal-oral route, is most common in developing countries in Asia, Africa, and Central America, where the disease is highly endemic. In industrialized countries, hepatitis E is infrequent, although in recent years, sporadic cases have been reported, resulting mainly from zoonotic transmission of HEV genotype 3 (1–3).

Prevalence rates of HEV IgG, a marker of previous exposure to HEV, range from 1% to 20% in industrialized countries (1). This marked variability in reported prevalence has been attributed to the use of different IgG assays with significantly different sensitivities (4).

The population of Israel comprises 2 major population groups, Jews (80%) and Arabs (including Muslims, Christians, and Druze); each has distinct cultural and socioeconomic features (5). In a study published in 1995, a low seroprevalence of anti-HEV antibodies in Israel was found among Jews (2.81%) and Arabs (1.81%) (6). These data were obtained by using an immunoassay developed 20 years ago; newer assays are considered more sensitive and specific to HEV IgG (4).

Dr. Mor is the head of the Clinical Virology Laboratory and the director of the National HIV and Hepatitis Reference Laboratory in the MOH in Israel. Her research interests include HIV resistance in high and low viral load conditions and viral hepatitis.

Acknowledgment

We thank Diagnostic Systems Italy for providing 2 HEV IgG detection kits.

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Tables

Suggested citation for this article: Mor O, Bassal R, Michaeli M, Wax M, Ram D, Cohen-Ezra O, et al. Prevalence of hepatitis E virus antibodies, Israel, 2009–2010. Emerg Infect Dis. 2015 Apr [date cited]. http://dx.doi.org/10.3201/eid2104.140245

DOI: 10.3201/eid2104.140245