Seroprevalence of hepatitis E virus (HEV) antibody and the possible association with chronic liver disease: a case-control study in Albania

A case-control study involving 109 in-patients with chronic liver disease and 190 in-patients with no apparent liver disease was conducted to evaluate the seroprevalence of anti-HEV antibodies and the possible association with chronic liver disease. Among cases, the anti-HEV prevalence was 36(.)6% which increased significantly by age; among controls, the prevalence was 12(.)1% (P < 0(.)05) and was similar among age groups < 60 years. Among cases, aged > 50 years (OR 4(.)0, 95% CI 1(.)4-11) and the presence of end stage liver disease (ESLD) (OR 4(.)3, 95% CI 1(.)4-12(.)8) were associated independently with anti-HEV positivity. The mean optical density, determined by anti-HEV immunoenzymatic test, was significantly higher among patients with ESLD, compared to the other patients. These results indicate that there is a high seroprevalence of anti-HEV in patients with chronic liver disease and a possible association between HEV infection and/or anti-HEV production and advanced stage chronic liver disease.