Original scientific paper
https://doi.org/10.20471/acc.2021.60.s1.08
Epidemiology of Hepatitis E Virus in Croatia: a Narrative Mini-Review
Anna Mrzljak
orcid.org/0000-0001-6270-2305
; Department of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Tatjana Vilibić-Čavlek
orcid.org/0000-0002-1877-5547
; School of Medicine, University of Zagreb, Zagreb, Croatia; Department of Virology, Croatian Institute of Public Health, Zagreb, Croatia
Abstract
Hepatitis E virus (HEV) infection is an emerging public health problem worldwide,
mainly presenting as acute self-limiting hepatitis, but extra-hepatic manifestations, as well as
chronic hepatitis in immunocompromised populations, have been more commonly recognized. The
seroprevalence ranges from 0.6% to 52.5% in Europe, depending on the geographical region and
population group tested. This narrative review focuses on HEV epidemiology in Croatia. The seroprevalence
studies show that HEV is widespread in Croatia, with significant differences among population
groups; healthcare professionals (2.7%), pregnant women (2.9%), general population (3.4%), injecting
drug users (6.1%), animal-related professions (4.0-8.1%), alcohol abusers (8.9%), war-related
PTSD patients (8.6%), patients with chronic liver diseases (15.1%), blood donors (21.5%), patients
after liver transplantation (24.4%) and patients on hemodialysis (5.2-43.4%). The data show that
HEV IgG positivity increases with age and is higher in continental than coastal parts of Croatia and
in suburban and rural areas. Phylogenetic analysis show that all detected HEV strains in Croatia were
identified as genotype 3. Since the emerging trends of HEV spreading are likely to continue, continuous
surveillance is important, especially in immunocompromised persons at risk of chronic hepatitis E.
Keywords
Hepatitis E virus; Croatia; Transplant; Hemodialysis; Epidemiology
Hrčak ID:
260296
URI
Publication date:
1.1.2021.
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