Risk factors for sporadic hepatitis E infection: a systematic review and meta-analysis

Hepatitis E virus (HEV) is one of the main causes viral hepatitis infection worldwide. Sources contamination can vary greatly according to geographical regions and HEV genotypes. endemic responsible for large waterborne epidemics involving human HEV-1 or HEV-2 genotypes in with limited sanitation, contrast industrialized countries, where mainly a foodborne zoonosis HEV-3 HEV-4 zoonotic Limited data on source attribution are available, all possible sources transmission pathways not fully identified. A systematic review meta-analysis case-control cohort studies (including transversal studies) were performed determine risk factors associated sporadic infection. Suitable scientific articles identified through literature search subjected methodological quality assessment. From each study, odds-ratio (OR) measures extracted/calculated, as well study characteristics such population type, design, factor hierarchy. Mixed-effects meta-analyses models adjusted by type appropriate partitions. Seventy-seven conducted between 1986 2016 investigating mixed population, susceptible pregnant women, included this meta-analysis. cases defined serological exams differentiated whenever exam symptoms. This parenteral pathway (blood transfusion, tattooing IV injection, dialysis hemodialysis), routes related contaminated water, animal contact (occupational exposure) consumption foods relevant With regards role food, suspected sometimes proven several studies, pig meat, pork sausages, game meat significant HEV, particular undercooked preparations containing liver. In addition, shellfish (oysters mussels), which accumulate when water environmentally (from origin), also detection anti-HEV antibodies. The results show that symptomatic infected share most explainable factors, agreement recent Europe. reveals some insufficiently treated shellfish, vegetables under-investigated. Future should include at but under-investigated, transplant recipients, women children, investigate other potential HEV.