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Meta-Analysis
. 2019 Jan 16;8(1):3.
doi: 10.1186/s40249-018-0514-4.

Seroprevalence of hepatitis E in adults in Brazil: a systematic review and meta-analysis

Fátima Mitiko Tengan  1   2 , Gerusa M Figueiredo  3 , Arielle K S Nunes  4 , Carol Manchiero  4 , Bianca P Dantas  4 , Mariana C Magri  4 , Thamiris V G Prata  4 , Marisa Nascimento  5 , Celso C Mazza  6   4 , Edson Abdala  6   4 , Antonio A Barone  6   4 , Wanderley M Bernardo  7   8
Affiliations
Meta-Analysis

Seroprevalence of hepatitis E in adults in Brazil: a systematic review and meta-analysis

Fátima Mitiko Tengan et al. Infect Dis Poverty. .

Abstract

Background: Hepatitis E virus (HEV) is a member of the Hepeviridae family; it has four main genotypes and one serotype. While genotypes 1 and 2 cause epidemic hepatitis and are transmitted via water and the fecal-oral route, genotypes 3 and 4 are zoonotic. In the various seroprevalence studies of hepatitis E in Brazil, the numbers reported vary widely and are difficult to interpret. The aim of this study was to analyze existing seroprevalence studies of hepatitis E in adults in Brazil.

Main text: We searched the PubMed, Latin American and Caribbean Health Sciences and Embase databases for studies published from inception to May 12, 2018 concerning infection by HEV in Brazil without time period or language restrictions. We included studies that presented data concerning hepatitis E seroprevalence in adults in Brazil, had a sample size ≥50 patients and whose method used for the detection of anti-HEV was standardized and commercialized. We also evaluated the quality of the articles using a list of criteria that totalized 9 items. Of the 20 studies ultimately analyzed, 10 (50%) were from the southeast region of Brazil, 3 (15%) were from the central-west region, 3 (15%) were from the northern region, 2 (10%) were from the northeast region and 2 (10%) were from the southern region. Regarding the quality evaluation of the studies, the mean score was 5.6 (range: 4-8). The estimated overall seroprevalence of HEV infection in the adult population was 6.0% (95% CI: 5.0-7.0); in subgroup analyses, we observed that the prevalence of anti-HEV antibodies in blood donors was 7.0% (95% CI: 5.0-8.0), whereas in the general population, it was 3.0% (95% CI: 2.0-4.0).

Conclusions: The results of this systematic review indicate that there should be national investment in the prevention of hepatitis E virus infection in Brazil, including the implementation of improvements in basic sanitation and guidance regarding the appropriate handling of animal waste and the optimal cooking of vegetables, meat and their derivatives.

Keywords: Brazil; Hepatitis E; Hepatitis E virus; Prevalence; Systematic review.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the identification, inclusion, and exclusion criteria of the study. * Three publications among the 14 included articles with more than one type of population, for a grand total of 20 studies
Fig. 2
Fig. 2
Seroprevalence of hepatitis E in adults in Brazil. GO: Goias; SP: São Paulo; SC: Santa Catarina; PR: Parana; RJ: Rio de janeiro; AM: Amazonas; BA: Bahia; MT: Mato Grosso
Fig. 3
Fig. 3
Seroprevalence of hepatitis E in blood donors in Brazil. SP: São Paulo; SC: Santa Catarina; PR: Parana; RJ: Rio de Janeiro; BA: Bahia
Fig. 4
Fig. 4
Seroprevalence of hepatitis E in the general population of Brazil. RJ: Rio de Janeiro;SP: São Paulo; MT: Mato Grosso
Fig. 5
Fig. 5
Seroprevalence of hepatitis E in studies using the Abbott commercial kit for anti-HEV antibody detection. PR: Parana; RJ: Rio de Janeiro; AM: Amazonas; SP: São Paulo; BA: Bahia
See this image and copyright information in PMC

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