Is Hepatitis E Virus a Neglected or Emerging Pathogen in Egypt?
Abstract
:1. Introduction
2. Zoonotic HEV Infection in Egypt
2.1. Ruminants
2.1.1. Cows
2.1.2. Buffalos
2.1.3. Goats
2.1.4. Sheep
2.2. Horse
2.3. Pigs
2.4. Rodents
2.5. Cat
3. Mode of HEV Transmission among Egyptians
3.1. Waterborne Infection (Fecal–Oral Transmission)
3.2. Foodborne Transmission
3.3. Blood Transfusion and HEV Transmission
3.4. Vertical Transmission
4. Hepatitis E Virus Is a Neglected Disease in Egypt despite the High Seropositivity Reported among Egyptians
4.1. Risk Factors of HEV Exposure for Egyptians
4.2. Coinfection of HEV with Other Endemic Hepatotropic Pathogens in Egypt (Table 2)
4.3. Waterborne Outbreaks Reported in Egypt
4.4. HEV Detection Is Neglected in Egyptian Hospitals
4.5. Recent Findings on the Status of HEV Infection in Egypt
5. Summary, Conclusions and Future Perspectives
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Governorate or Region | Study Subject | HEV Markers Tested | Main Findings | Risk Factors | Reference |
---|---|---|---|---|---|
Cairo | Acute hepatitis children (n = 261) |
| anti-HEV IgM was detected in 22% of children | Living in home not connected to a municipal source of water | [58] |
Acute hepatitis adults (n = 219), from whom 143 patients were included in analysis |
|
| Age and rural residents | [59] | |
Greater Cairo (Cairo, Giza and, El Qalyoubia) | Acute hepatitis patients (n = 1950) |
|
|
| [60] |
Nile Delta | Residents of villages (healthy subjects, n= 155) |
|
| Village, low sanitation | [61] |
Pregnant women (n= 2428) in the second and third trimesters from three villages |
|
|
| [55] | |
Nile Delta + Upper Egypt (Initial study) | Villagers from two Egyptian rural communities
|
|
| Village, low sanitation, rural communities, rural habits. | [62] |
Nile Delta + Upper Egypt Follow up Study | Follow up study was done 10.7 later months on villagers (n = 2411) who participated in the study [62] |
|
|
| [43] |
Nile Delta (Mansoura Governate) + Upper Egypt (Asyut Governate) | Acute hepatitis patients (n= 287) |
|
|
| [18] |
Nile Delta Kafr El Sheikh Governate | 1850 villagers representing 68% of the total population |
|
|
| [63] |
|
|
|
| [42] | |
Nile Delta Dakahlia Governate (Mansoura) | Acute hepatitis children (n = 180) |
|
|
| [64] |
Asymptomatic pregnant women (n = 116)Two groups: Group1: HCV seropositive (n-56) Group2: HCV seronegative (n-60) |
|
|
| [65] | |
β-thalassemia children (n = 140) |
|
|
| [66] | |
Nile Delta Gharbia Governorate | village residents n = 2085, from which 505 were active HCV-infected patients |
|
|
| [67] |
Alexandria | healthy adolescent females (n = 95), from whom 10 were pregnant. |
|
|
| [68] |
Acute hepatitis patients (n = 202 samples) |
|
|
| [20] | |
Asyut Governate | Acute hepatitis patients (n = 235) & asymptomatic contacts (n = 200) | Anti-HEV IgM and anti-HEV IgG | HEV was detected in 16% of acute hepatitis patients and 7% of asymptomatic contacts. |
| [53] |
Acute hepatitis children (n = 123) | Anti-HEV IgM and anti-HEV IgG | HEV was detected in 30.9% of the patients |
| [69] | |
Acute hepatitis of unknown etiology (AHUE), Hepatitis of non-A-C (n = 300) |
|
|
| [21] |
Coinfection | HEV Markers Tested | Findings | Region | Reference |
---|---|---|---|---|
HEV/HAV | Anti-HEV IgM and IgG |
| Dakahlya Governorate (Mansoura) | [121] |
HEV/HBV | Anti-HEV IgM and IgG |
| Dakahlya Governorate (Mansoura) | [121] |
Anti-HEV antibodies (IgM and IgG) & HEV RNA |
| Greater Cairo | [60] | |
Total anti-HEV antibodies |
| Qena Governorate, Upper Egypt | [57] | |
HEV/HCV | Anti-HEV antibodies (IgM and IgG) & HEV RNA |
| Greater Cairo | [60] |
Anti-HEV IgM and IgG |
| Dakahlya Governorate (Mansoura) | [121] | |
Anti-HEV IgG |
| Gharbia Governorate, Basyoun, Nagreej village | [67] | |
Anti-HEV IgG |
| Dakahlya Governorate | [65] | |
Total anti-HEV antibodies |
| Qena Governorate, Upper Egypt | [57] | |
HEV/HBV/HCV | Total anti-HEV antibodies |
| Qena Governorate, Upper Egypt | [57] |
Anti-HEV IgM and IgG |
| Dakahlya Governorate (Mansoura) | [121] | |
Anti-HEV antibodies (IgM and IgG) & HEV RNA |
| Greater Cairo | [60] | |
HEV/S. mansoni |
|
| Rural communities | [113] |
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Sayed, I.M.; Abdelwahab, S.F. Is Hepatitis E Virus a Neglected or Emerging Pathogen in Egypt? Pathogens 2022, 11, 1337. https://doi.org/10.3390/pathogens11111337
Sayed IM, Abdelwahab SF. Is Hepatitis E Virus a Neglected or Emerging Pathogen in Egypt? Pathogens. 2022; 11(11):1337. https://doi.org/10.3390/pathogens11111337
Chicago/Turabian StyleSayed, Ibrahim M., and Sayed F. Abdelwahab. 2022. "Is Hepatitis E Virus a Neglected or Emerging Pathogen in Egypt?" Pathogens 11, no. 11: 1337. https://doi.org/10.3390/pathogens11111337