Hepatitis E virus and hepatitis A virus exposures in an apparently healthy high-risk population in Italy
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CLINICAL AND EPIDEMIOLOGICAL STUDY
Hepatitis E virus and hepatitis A virus exposures in an apparently healthy high-risk population in Italy M. Rapicetta • R. Monarca • L. A. Kondili • P. Chionne • E. Madonna G. Madeddu • A. Soddu • A. Candido • S. Carbonara • M. S. Mura • G. Starnini • S. Babudieri
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Received: 24 March 2012 / Accepted: 7 December 2012 / Published online: 22 December 2012 Ó Springer-Verlag Berlin Heidelberg 2012
Abstract Purpose The prevalence of anti-hepatitis E virus (HEV) and anti-hepatitis A virus (HAV), as well as the possible links with socio-demographic and other viral risks factors, were evaluated in an inmates population. Methods The study population consisted of 973 consecutively recruited inmates of eight Italian prisons. Results The anti-HEV prevalence was 11.6 % (113/973). It increased significantly by age (v2 for linear trend: p = 0.001) and was significantly higher among non-Italian compared to Italian inmates (15.3 vs. 10.7 %, respectively). Age [40 years [odds ratio (OR) 2.1; 95 % confidence interval (CI) 1.4–3.1], non-Italian citizenship (OR 1.8; 95 % CI 1.1–2.9) and anti-HIV seropositivity (OR 2.2; 95 % CI 1.2–4.2) were the only factors independently associated to anti-HEV positivity by logistic regression M. Rapicetta (&) P. Chionne E. Madonna A. Candido Viral Hepatitis Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanita`, Viale Regina Elena, 299-00161 Rome, Italy e-mail: [email protected] R. Monarca Infectious Diseases Unit, Belcolle Hospital, Viterbo, Italy L. A. Kondili National Center for Immunobiologicals Research and Evaluation (CRIVIB), Istituto Superiore di Sanita`, Rome, Italy G. Madeddu A. Soddu M. S. Mura S. Babudieri Department of Infectious Diseases, University of Sassari, Sassari, Italy S. Carbonara Infectious Diseases Clinic, University of Bari, Bari, Italy G. Starnini Penitentiary Department, Ministry of Justice, Rome, Italy
analysis. The overall anti-HAV prevalence was 86.4 %, and was significantly higher in non-Italian compared to Italian prisoners (92.6 vs. 84.9 %, respectively; p = 0.02). Age older than 40 years (OR 3.6; 95 % CI 2.2–5.9), \5 years formal education (OR 2.1; 95 % CI 1.3–3.2) and non-Italian nationality (OR 2.7; 95 % CI 1.5–4.8) were factors independently associated to anti-HAV positivity by the logistic regression analysis. Conclusions Compared to the general population, significantly higher anti-HEV and anti-HAV prevalences were observed in an inmates population in Italy. Old age and non-Italian nationality were factors independently related to both HEV and HAV exposures. This data suggest the important role of low socio-economic factors in the transmission of both infections in high-risk populations. The possible epidemiological and/or pathogenetic links between HEV and HIV exposures need to be studied further. Keywords Anti-HEV Anti-HAV Anti-HIV Infection prevalence Inmates
Introduction Infections from hepatitis A virus (HAV) and hepatitis E virus (HEV) are related
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