Seroprevalence and risk factors for hepatitis E virus infection in the Romanian adult population: a cross-sectional study in a tertiary hospital

Background: The primary goal was to estimate the seroprevalence of autochthonous hepatitis E virus (HEV) infection in adult Romanian population. Additionally, we aimed to identify the risk factors associated with the HEV seropositive status. Methods: Between January 2015 and December 2016, 201 adult patients were tested for anti-HEV-IgG. Multivariate logistic regression was used to examine for factors associated with a positive HEV-IgG test. The level of significance was set at a = 0.05. Results: The final analysis included 175 patients who followed the study protocol. Forty-sex (26.3%) had positive, 121 (69.1%) had negative, and 8 (4.6%) had indeterminate anti-HEV-IgG results. Patients with positive anti-HEV-IgG were older [median age: 54.5 years (IQR 43-65)] compared to patients with negative anti-HEV-IgG [median age: 37.5 years (IQR 28-57.5)], p < 0.001. A positive HEV-IgG was more common in patients with history of blood transfusions [n=10 (22.7%) versus (vs) n=11 (9.4%), p=0.025], in those with immunosuppressive conditions [n=18 (40.9%) vs n=27 (23.1%), p=0.025] and in patients with positive hepatitis B surface antigen (HBsAg) [n=14 (31.1%) vs n=10 (10.3%), p=0.002]. Conclusions: In conclusion, we found that autochthonous HEV seropositivity is common in our study population, especially in older patients, previous blood transfusions, presence of immunosuppressive conditions, and positive HBsAg.