Anti-hepatitis E virus antibody prevalence in French expatriate workers

Objective: The hepatitis E virus (HEV) is a leading cause of acute hepatitis in developing countries and an emerging pathogen in Europe. HEV seroprevalence has rarely been assessed in cohorts of travelers, and previous studies have reported a very low rate of exposure. We assessed HEV seroprevalence in French expatriate workers. Methods: The prevalence of HEV IgG and IgM was assessed among 43 French expatriate workers using two commercial microplate enzyme immunoassays (Adaltis and Wantai). Additionally HEV IgG-positive sera were tested with an immunoblot assay (recomLine), while IgM-positive sera were tested with a rapid immunochromatographic assay (Assure). Results: The prevalence of anti-HEV IgG was 3.7 times higher in French expatriates than in comparable blood donors from the same area. A discrepancy was evidenced between the HEV IgG results obtained by the Wantai and Adaltis assays (48.8% vs. 30.2%). Conclusions: Expatriation from France, including to areas not recognized as hyperendemic for HEV, may expose individuals to HEV infection. This issue warrants further study; in particular, serology should be compared before and after travel. The most sensitive Wantai serological assay should be used for epidemiological studies to obtain better insight into the epidemiology of HEV. (C) 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.