Hepatitis E Virus Prevalence Amongst Blood Donors in Kenya

  • Alex Kiprotich Mutai Mount Kenya University
  • E Songok Kenya Medical Research Institute Graduate School
  • Kennedy K Muna Mount Kenya University
  • B Langat University of Kabianga, Kericho; Kenya
  • J Borlang National Microbiology Laboratory, Winnipeg, Canada
  • A Andonov University of Manitoba, Winnipeg, Canada
DOI: https://doi.org/10.21276/apalm.3193
Keywords: Hepatitis E, Seroprevalence, Blood donors, Endemic

Abstract

Introduction: Hepatitis E (HEV) is an emerging cause of viral hepatitis mainly transmitted through the fecal-oral and parenteral routes. It has greatly affected populations in many parts of Kenya due to declined sanitation practices.  The objective of the research was to determine IgM and IgG seroprevalence of HEV prevalence among blood donors in Kenya as well as its Anti-HEV sero-reactivity by demographic factors. Material and Methods: Cross sectional research design was used to collect blood samples from six from regional blood collecting centers, with blood donors selected through proportionate stratified sampling. Serum were matched to the age and gender distribution of the blood donors and tested by IgM and IgG enzyme immunoassays (EIA). The screening was carried out using human MP Diagnostics (0721150096T-96 wells) HEV ELISA kit. To test for IgM and IgM anti-HEV antibodies, microplates with 96-well plate were used. Results were averaged to generate a signal-to-noise ratio with ≥1.0 designated as positive per the manufacturer’s recommended cutoff. Result and Conclusion: On the analysis, IgM reactivity was associated with HEV (RR 1.66, 95%CI 1.07, 2.60; p = 0.024) while IgG reactivity was associated with increasing age (p < 0.001) and HIV (RR 1.93, 95%CI 1.52, 2.46; p < 0.001). AFI case-patients were more likely to be IgM (p = 0.002) and IgG (p<0.001) reactive compared to healthy residents. All the 19 hepatitis E virus IgM and/or IgG seropositive blood samples tested negative for HEV RNA since no bands were detected using RT-PCR technique. Serologic evidence for HEV in blood samples from selected areas suggests a high burden of infection, though age and gender exhibited no significant difference in prevalence of HEV among the blood donors in Kenya (p>0.05).

References

Drobeniuc, J., Meng, J., Reuter, G., Greene-Montfort, T., Khudyakova, N., Dimitrova, Z., . . . Teo, C.-G. (2010). Serologic assays specific to immunoglobulin M antibodies against hepatitis E virus: pangenotypic evaluation of performances. Clinical Infectious Diseases, 51(3), e24-e27.

Furukawa, N., Teshale, E., Cosmas, L., Ochieng, M., Gikunju, S., Fields, B., & Montgomery, J. (2016). Serologic evidence for hepatitis E virus infection among patients with undifferentiated acute febrile illness in Kibera, Kenya. Journal of Clinical Virology, 77, 106-108.

Faber, M. S., Wenzel, J. J., Jilg, W., Thamm, M., Höhle, M., & Stark, K. (2012). Hepatitis E virus seroprevalence among adults, Germany. Emerging infectious diseases, 18(10), 1654.

WHO, 2019. Hepatitis E

BPAC, N. (2012). Best Practice Journal 44. Update on oxycodone: what can primary care do about the problem.

Centers for Disease Control and Prevention. (2014). CDC.(2015). HIV Surveillance Supplemental Report, 17(4).

Aggarwal, R. (2013). Diagnosis of hepatitis E. Nature reviews Gastroenterology & hepatology, 10(1), 24.

Kmush, B., Wierzba, T., Krain, L., Nelson, K., & Labrique, A. B. (2013). Epidemiology of hepatitis E in low-and middle-income countries of Asia and Africa. Paper presented at the Seminars in liver disease.

Liang, X., Bi, S., Yang, W., Wang, L., Cui, G., Cui, F., Chen, Y. (2009). Epidemiological serosurvey of hepatitis B in China—declining HBV prevalence due to hepatitis B vaccination. Vaccine, 27(47), 6550-6557.

Kamar, N., Dalton, H. R., Abravanel, F., & Izopet, J. (2014). Hepatitis E virus infection. Clinical microbiology reviews, 27(1), 116-138.

O'Meara, W. P., Mott, J. A., Laktabai, J., Wamburu, K., Fields, B., Armstrong, J., . . . Menya, D. (2015). Etiology of pediatric fever in western Kenya: a case–control study of falciparum malaria, respiratory viruses, and streptococcal pharyngitis. The American journal of tropical medicine and hygiene, 92(5), 1030-1037.

Steere, A. C., McHugh, G., Damle, N., & Sikand, V. K. (2008). Prospective study of serologic tests for Lyme disease. Clinical Infectious Diseases, 47(2), 188-195

Jens and David, 2014 Dreier, J., & Juhl, D. (2014). Autochthonous hepatitis E virus infections: a new transfusion-associated risk?. Transfusion Medicine and Hemotherapy, 41(1), 29-39.

Jothikumar, N., Cromeans, T. L., Robertson, B. H., Meng, X., & Hill, V. R. (2006). A broadly reactive one-step real-time RT-PCR assay for rapid and sensitive detection of hepatitis E virus. Journal of virological methods, 131(1), 65-71.

Ochwoto, M., Kimotho, J. H., Oyugi, J., Okoth, F., Kioko, H., Mining, S., . . . Songok, E. (2016). Hepatitis B infection is highly prevalent among patients presenting with jaundice in Kenya. BMC infectious diseases, 16(1), 101.

Renou, C., Lafeuillade, A., Cadranel, J.-F., Pavio, N., Pariente, A., Allègre, T., . . . Nicand, E. (2010). Hepatitis E virus in HIV-infected patients. Aids, 24(10), 1493-1499.

Boutrouille, A., Bakkali-Kassimi, L., Crucière, C., & Pavio, N. (2007). Prevalence of anti-hepatitis E virus antibodies in French blood donors. Journal of clinical microbiology, 45(6), 2009-2010.

D'acremont, V., Kilowoko, M., Kyungu, E., Philipina, S., Sangu, W., Kahama-Maro, J., . . . Genton, B. (2014). Beyond malaria—causes of fever in outpatient Tanzanian children. New England Journal of Medicine, 370(9), 809-817.

Hagan, H., Jordan, A. E., Neurer, J., & Cleland, C. M. (2015). Incidence of sexually-transmitted hepatitis C virus infection in HIV-positive men who have sex with men: A systematic review and meta-analysis. AIDS (London, England), 29(17), 2335.

Hoofnagle, J. H., Nelson, K. E., & Purcell, R. H. (2012). Hepatitis e. New England Journal of Medicine, 367(13), 1237-1244.

Purcell, R., & Emerson, S. (2008). Hepatitis E: an emerging awareness of an old disease. Journal of hepatology, 48(3), 494-503

Published
2022-10-01
Issue
Vol 9 No 9 (2022)
Section
Original Article

Copyright (c) 2022 Alex Kiprotich Mutai, E Songok, Kennedy K Muna, B Langat, J Borlang, A Andonov

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).