Dragan Deli},
Zorica Ne{i},
Sonja @erjav,
Ivana Pe{i},
Nata{a Popovi},
Jasmina Simonovi}
Hepatitis E virus infection in Serbia
Address correspondence to:
Professor Dr Dragan Delic,
Institut za infektivne i tropske bolesti
Bulevar
JA 16, 11000 Belgrade, Serbia
E-mail: infektro@EUnet.yu
Gastroenterolo{ka sekcija SLD-
01751, 2003.
Liver and biliary tract
Jetra i bilijarni trakt
Institute of Infectious and Tropical Diseases CSS,
Belgrade, Serbia
ARCH GASTROENTEROHEPATOL 2003; 22 ( No 3 - 4 ): 53 - 56
Hepatitis E virus infection
in Serbia: Epidemiology
and clinical features
Hepatitis E virusna infekcija u Srbiji:
Epidemiologija i klini~ka slika
(accepted September 15th, 2003)
Abstract
Antibody to hepatitis E virus of IgG class (anti-HEV IgG) is regularly detected in indu- strialized coun-
tries, where HEV is non-endemic, at the levels not exceeding 1.1-3%.
Our pilot study indicates that HEV infection is endemic in Serbia since the prevalence of infections
among our population is significantly high (78/538; 14.4%). High seroprevalence in male homosexuals
(6/22; 27.2%) and prostitutes (13/40; 32.5%) may be explained by life-style and lack of the preventive
hygienic measures. Our results indicate that parenteral transmission of hepatitis E virus, i.e., transmis-
sion via the blood and blood derivatives has no epidemiological significance in our population; anti-HEV
IgG antibodies were evidenced in 9.3% (8/86) of the HIV-positive intravenous drug users, 7.6% (2/26)
hematological patients, 4.1% (2/48) of patients undergoing hemodialysis, but there not evidenced in 24
tested hemophiliacs.
High prevalence among blood donors (35/206; 16.9%) may be explained by poor socioeconomic situa-
tion, and low level of personal and collective hygiene as well as unregulated supply of drinking water in
some parts of country.
We have treated 24 patients with icteric form of acute viral hepatitis E. Clinical course of the disease
was usual and self-limiting with normalization of the biochemical analyses within 64 days (range 43-85
days) after onset of the disease. None of the patients had
fulminant course of the disease with acute liver
failure, and none of them developed chronic liver failure.
Key Words:
hepatitis E virus infection,
hepatitis E,
seroprevalence
Sa`etak
Antitela na hepatitis E virus IgG klase ( anti-HEV IgG) se redovno dokazuju i u visoko-
razvijenim zemljama koje nisu endemi~ne za HEV,ali ne prelaze nivo od 1.1-3%.
Na{a pilot studija ukazuje da je HEV infekcija endemi~na u Srbiji jer je proku`enost na{eg stanovni{tva
zna~ajno visoka (78/538; 14.4%).Visoka seroprevalenca kod mu{kih homoseksualaca (6/22; 27.2%) i pros-
titutki (13/40; 32.5%) mo`e se objasniti stilom `ivota i odsustvom preventivnih higijenskih mera. Na{i
rezultati ukazuju da parenteralni prenos, odnosno prenos putem krvi i derivata krvi hepatitis E virus nema
epidemiolo{ki zna~aj u na{oj populaciji; anti-HEV IgG antitela smo dokazali kod 9.3% (8/86), HIV pozi-
tivnih i.v.narkomana, 7.6% (2/26) hematolo{kih bolesnika, 4.1% (2/48)bolesnika na hemodijalizi, a nismo
ih dokazali kod 24 testiranih hemofili~ara.
Visoka seroprevalenca kod dobrovoljnih davaoca krvi ( 35/ 206; 16.9%) mo`e se objasniti lo{im ekonom-
skim prilikama,ali i niskim stepenom li~ne i kolektivne higijene,kao i neregulisanim snabdevanjem
pija}om vodom u nekim sredinama. Le~ili smo 24 bolesnika sa ikteri~nom formom akutnog hepatitisa E.
Klini~ki tok bolesti je bio uobi~ajen i samoograni~avaju}i sa normalizacijom biohemijskih analiza unutar
64 dana (raspon 43-85 dana) od po~etka bolesti.Nijedan bolesnik nije imao fulminantni tok bolesti sa akut-
nom insuficijencijom jetre,niti je razvio hroni~nu bolest jetre.
Klju~ne re~i:
hepatitis E virusna infekcija,
hepatitis E,
seroprevalenca
