Elevated HEV Seroprevalence in Hepatitis B and Unexplained Hepatitis in Central Vietnam

Overview

This study found a high seroprevalence of hepatitis E virus (HEV) antibodies among patients with hepatitis B virus (HBV) infection and those with hepatitis of unknown etiology (HUE) in Central Vietnam. Despite elevated anti-HEV IgG rates, active HEV infection was rare, and no association was observed between HEV exposure and liver disease progression.

Background

Hepatitis E virus (HEV) is a major cause of acute viral hepatitis, especially in regions with poor sanitation. Co-infection with HBV is common in populations with chronic liver disease, but data on HEV prevalence in Southeast Asia remain limited. Vietnam is endemic for HBV and a hotspot for zoonotic HEV due to high pig production and consumption. Understanding HEV seroprevalence in HBV-infected individuals is critical to assess its impact on liver disease progression.

Data Highlights

Key Findings

• Anti-HEV IgG seroprevalence was 26% in HBV-infected patients and 36% in those with hepatitis of unknown etiology.
• Patients with liver cirrhosis and hepatocellular carcinoma had the highest HEV seroprevalence (46%) among HBV patients.
• Only one patient (0.1%) tested positive for anti-HEV IgM, indicating recent infection was rare.
• No HEV RNA was detected in any patient, suggesting absence of active HEV infection.
• Biochemical liver parameters did not correlate with HEV seropositivity, indicating no association with liver disease progression.
• HEV is not a common cause of hepatitis in Central Vietnam despite high seroprevalence.

Clinical Implications

Clinicians should be aware of the relatively high exposure to HEV among patients with chronic liver disease in Central Vietnam, especially those with HBV. However, routine screening for active HEV infection may not be warranted given the low incidence of acute infection and lack of association with disease progression. Preventive measures focusing on sanitation and food safety remain important to reduce HEV transmission in endemic areas.

Conclusion

HEV exposure is common among individuals with HBV and unexplained hepatitis in Central Vietnam, but active infection is rare and does not appear to influence liver disease progression. HEV is unlikely to be a major contributor to hepatitis cases in this region.

References

1. Study Authors/2024 -- Elevated Seroprevalence of Hepatitis E Virus in Individuals with Hepatitis B and Unexplained Hepatitis Cases in Central Vietnam