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Prevalence of Hepatitis E Virus Antibodies, Israel, 2009–2010 - Volume 21, Number 4—April 2015 - Emerging Infectious Disease journal - CDC


Prevalence of Hepatitis E Virus Antibodies, Israel, 2009–2010 - Volume 21, Number 4—April 2015 - Emerging Infectious Disease journal - CDC

Volume 21, Number 4—April 2015


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)


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 (14). 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 (13).
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.


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


  1. Aggarwal RHepatitis E. Historical, contemporary and future perspectives. J Gastroenterol Hepatol. 2011;26(Suppl 1):72–82. PubMed DOI
  2. Dalton HRHunter JGBendall RPHepatitis ECurr Opin Infect Dis2013;26:471–8. PubMed DOI
  3. Kamal SMMahmoud SHafez TEl-Fouly R. Viral hepatitis A to E in South mediterranean countries. Mediterr J Hematol Infect Dis.2010;2:e2010001. PubMed DOI
  4. Pas SDStreefkerk RHPronk Mde Man RABeersma MFOsterhaus ADDiagnostic performance of selected commercial HEV IgM and IgG ELISAs for immunocompromised and immunocompetent patients. J Clin Virol. Dec;58(4):629–34. PubMed http://dx.doi.org10.1016/j.jcv.2013.10.010
  5. Central Bureau of Statistics. Israel. Population. Statistical Abstracts of Israel, No. 64. 2013 [cited 11 Feb 2014].http://www.cbs.gov.il/shnaton64/st_eng02.pdf
  6. Karetnyi YVFavorov MOKhudyakova NSWeiss PBar-Shani SHandsher RSerological evidence for hepatitis E virus infection in Israel. J Med Virol1995;45:316–20. PubMed DOI
  7. Central Bureau of Statistics. Israel. Society and welfare. Statistical abstracts of Israel, no. 64. 2013 [cited 11 Feb 2014];http://www.cbs.gov.il/shnaton64/st_eng07.pdf
  8. Olsen BAxelsson-Olsson DThelin AWeiland O. Unexpected high prevalence of IgG-antibodies to hepatitis E virus in Swedish pig farmers and controls. Scand J Infect Dis2006;38:55–8. PubMed DOI
  9. Christensen PBEngle REHjort CHomburg KMVach WGeorgsen JTime trend of the prevalence of hepatitis E antibodies among farmers and blood donors: a potential zoonosis in Denmark. Clin Infect Dis2008;47:1026–31. PubMed DOI
  10. Dalton HRStableforth WThurairajah PHazeldine SRemnarace RUsama WAutochthonous hepatitis E in Southwest England: natural history, complications and seasonal variation, and hepatitis E virus IgG seroprevalence in blood donors, the elderly and patients with chronic liver disease.Eur J Gastroenterol Hepatol2008;20:784–90. PubMed DOI
  11. Arankalle VATsarev SAChadha MSAlling DWEmerson SUBanerjee KAge-specific prevalence of antibodies to hepatitis A and E viruses in Pune, India, 1982 and 1992. J Infect Dis1995;171:447–50. PubMed DOI
  12. Mansuy JMBendall RLegrand-Abravanel FSaune KMiedouge MEllis VHepatitis E virus antibodies in blood donors, France. Emerg Infect Dis.2011;17:2309–12. PubMed DOI
  13. Lachish TTandlich MSchwartz E. Acute hepatitis in Israeli travelers. J Travel Med. 2013;20:232–6. PubMed DOI
  14. Pourpongporn PSamransurp KRojanasang PWiwattanakul SSrisurapanon SThe prevalence of anti-hepatitis E in occupational risk groups.[PubMed]J Med Assoc Thai2009;92(Suppl 3):S3842.PubMed
  15. Pappas G. Socio-economic, industrial and cultural parameters of pig-borne infections. Clin Microbiol Infect2013;19:605–10. PubMed DOI


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

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