Hepatitis E antibodies in Egyptian adolescent females: their prevalence and possible relevance.

Hepatitis E virus has been implicated as a frequent cause of acute sporadic hepatitis among Egyptian children. Moreover, an extraordinarily high seroprevalence rate was previously reported in a semiurban Nile Delta population. A conspicuous feature of hepatitis E is the high morbidity and mortality it can cause among infected pregnant women. We therefore evaluated the prevalence of HEV antibodies in adolescent females using a solid-phase enzyme linked immunoassay based on two recombinant hepatitis E virus antigens. A high prevalence rate (38.9%) was found in 95 apparently healthy adolescent females. The mean age of the study subjects was 21.81 +/- 2.5 (SD) range 16-25 years. Eighty (84.2%) subjects resided in Alexandria, while 15 (15.8%) came from semiurban villages of Alexandria Governorate. An increased prevalence was noted with age, as anti-HEV antibodies were detected in 32.1% and 41.8% of study participants in the second and third decades of life, respectively. Similarly, those illiterate or having received less than primary education exhibited a higher HEV prevalence than those with higher education (46.3% vs 29.3%). The majority of subjects having serological evidence of HEV infection denied previous history of jaundice which shows that HEV infection was subclinical in those cases. Ten (55.6%) pregnant females participating in the study, as well as 48 (62.3%) non pregnant females lacked serological evidence of HEV infection; i.e., 60.01% (10 + 48 out of 95) of women in the childbearing age may be susceptible to infection. This report suggests that HEV is endemic in Alexandria, Egypt; the epidemiologic risk factors associated with HEV infection need further exploration.