Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 3, March, p. 351–355

doi: 10.17219/acem/65787

Publication type: original article

Language: English

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Exposure to hepatitis E virus, hepatitis A virus and Borrelia spp. infections in forest rangers from a single forest district in western Poland

Maciej Bura1,A,B,C,D,E,F, Alicja Bukowska2,A,B,E, Michał Michalak3,C,D, Aleksandra Bura4,B,C,D, Mariusz J. Nawrocki5,6,B,D, Marek Karczewski7,A,C,E, Iwona Mozer-Lisewska1,E,F

1 Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Poznan University of Medical Sciences, Poland

2 Regional Blood Center in Poznań, Poland

3 Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poland

4 Department of Infectious Diseases, Jozef Strus Multidisciplinary Municipal Hospital in Poznań, Poland

5 Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, Poland

6 Department of Anatomy, Poznan University of Medical Sciences, Poland

7 Department of General and Transplant Surgery, Poznan University of Medical Sciences, Poland


Background. Hepatitis E virus (HEV) infection is an emerging problem in developed countries. At least 2 zoonotic genotypes of the virus (HEV-3 and HEV-4) infect human beings. There are some data suggesting that forest rangers (FRs) can be at a higher risk of contact with HEV.
Objectives. The aim of this study was to assess the prevalence of HEV exposure markers in FRs from a single forest district in Greater Poland in relation to anti-HAV (hepatitis A virus) IgG, and anti-Borrelia spp. IgM and IgG antibodies.
Material and Methods. In total, 138 participants (48 FRs and 90 blood donors – BDs) were tested for anti-HEV IgM and IgG (EUROIMMUN Medizinische Labordiagnostika AG, Luebeck, Germany) and 96 individuals (48 FRs and 48 BDs) were tested for anti-HAV IgG (ARCHITECT immunoassays, Abbott Laboratories, Wiesbaden, Germany); anti-Borrelia IgM and IgG (EUROIMMUN kits) were assessed in FRs only.
Results. Anti-HEV markers were detected in 3 participants (2.2%; IgM in 1 FR, IgG in 2 BDs), less frequently than anti-HAV (16 out of 96 individuals, about 17%; FRs 19% vs BDs 15%) or anti-Borrelia antibodies (18 out of 48 individuals, 37.5%) (p < 0.0001 for both). Older study participants (≥45 years of age) were more frequently HAV-seropositive (29% vs 4% of the younger individuals; p = 0.0012).
Conclusion. We failed to unequivocally prove HEV exposure in FRs. The HAV seroprevalence in this study paralleled the situation in the general population. Exposure to Borrelia spp. in FRs was common.

Key words

hepatitis A virus, hepatitis E virus, Borrelia, seroprevalence, Poland

References (30)

  1. Rein DB, Stevens GA, Theaker J, Wittenborn JS, Wiersma ST. The global burden of hepatitis E virus genotypes 1 and 2 in 2005. Hepatology.
  2. Tsang TH, Denison EK, Williams HV, Venczel LV, Ginsberg MM, Vugia DJ. Acute hepatitis E infection acquired in California. Clin Infect Dis. 2000;30:618–619.
  3. Inoue J, Ueno Y, Nagasaki F, et al. Sporadic acute hepatitis E occurred constantly during the last decade in northeast Japan. J Gastroenterol.
  4. Lapa D, Capobianchi MR, Garbuglia AR. Epidemiology of hepatitis E virus in European countries. Int J Mol Sci. 2015;16:25711–25743.
  5. Smith DB, Simmonds P, Jameel S, et al.; International Committee on Taxonomy of Viruses Hepeviridae Study Group. Consensus proposals for classification of the family Hepeviridae. J Gen Virol. 2014;95:2223–2232.
  6. Lee GH, Tan BH, Chi-Yuan Teo E, et al. Chronic infection with camelid hepatitis E virus in a liver transplant recipient who regularly consumes camel meat and milk. Gastroenterology. 2016;150:355–357.
  7. Said B, Ijaz S, Kafatos G, et al.; Hepatitis E Incident Investigation Team. Hepatitis E outbreak on cruise ship. Emerg Infect Dis. 2009;15:1738–1744.
  8. Crossan CL, Simpson KJ, Craig DG, et al. Hepatitis E virus in patients with acute severe liver injury. World J Hepatol. 2014;6:426–434.
  9. Lewis HC, Wichmann O, Duizer E. Transmission routes and risk factors for autochthonous hepatitis E virus infection in Europe: A systematic review. Epidemiol Infect. 2010;138:145–166.
  10. De Schryver A, De Schrijver K, François G, et al. Hepatitis E virus infection: An emerging occupational risk? Occup Med (Lond). 2015;65:667–672.
  11. Ivanova A, Tefanova V, Reshetnjak I, et al. Hepatitis E virus in domestic pigs, wild boars, pig farm workers, and hunters in Estonia. Food Environ Virol. 2015;7:403–412.
  12. Karetnyi YV, Gilchrist MJ, Naides SJ. Hepatitis E virus infection prevalence among selected populations in Iowa. J Clin Virol. 1999;14:51–55.
  13. Dremsek P, Wenzel JJ, Johne R, et al. Seroprevalence study in forestry workers from eastern Germany using novel genotype 3- and rat hepatitis E virus-specific immunoglobulin G ELISAs. Med Microbiol Immunol. 2012;201:189–200.
  14. Carpentier A, Chaussade H, Rigaud E, et al. High hepatitis E virus seroprevalence in forestry workers and in wild boars in France. J Clin Microbiol. 2012;50:2888–2893.
  15. Chaussade H, Rigaud E, Allix A, et al. Hepatitis E virus seroprevalence and risk factors for individuals in working contact with animals. J Clin Virol. 2013;58:504–508.
  16. Yoon Y, Jeong HS, Yun H, et al. Hepatitis E virus (HEV) seroprevalence in the general population of the Republic of Korea in 2007–2009: A nationwide cross-sectional study. BMC Infect Dis. 2014;14:517.
  17. Jothikumar N, Cromeans TL, Robertson BH, Meng XJ, Hill VR. A broadly reactive one-step real-time RT-PCR assay for rapid and sensitive detection of hepatitis E virus. J Virol Methods. 2006;131:65–71.
  18. Fogeda M, de Ory F, Avellón A, Echevarría JM. Differential diagnosis of hepatitis E virus, cytomegalovirus and Epstein-Barr virus infection in patients with suspected hepatitis E. J Clin Virol. 2009;45:259–261.
  19. Richard S, Oppliger A. Zoonotic occupational diseases in forestry workers – Lyme borreliosis, tularemia and leptospirosis. Ann Agric Environ Med. 2015;22:43–50.
  20. Sadkowska-Todys M, Baumann-Popczyk A, Wnukowska N, Pop-czyk B, Kucharczyk B, Gołąb E. Occurrence and prevalence of selected zoonotic agents: Echinococcus multilocularis, Trichinella spiralis and hepatitis E virus (HEV) in the population of Polish hunters – Results of the study conducted in 2010–2012. Przegl Epidemiol. 2015;69:673–678.
  21. Bura M, Michalak M, Chojnicki M, Czajka A, Kowala-Piaskowska A, Mozer-Lisewska I. Seroprevalence of anti-HEV IgG in 182 Polish patients. Postepy Hig Med Dosw. 2015;69:320–326.
  22. Ślusarczyk J, Szemraj J, Jabłkowska-Górecka K, Juszczyk G, Białkowska J. Koinfekcja wirusem zapalenia wątroby typu E (HEV) u pacjentów zakażonych wirusem zapalenia wątroby typu C (HCV). Przegl Epidemiol. 2015;69(Suppl 1):13.
  23. Dreier J, Juhl D. Autochthonous hepatitis E virus infections: A new transfusion-associated risk? Transfus Med Hemother. 2014;41:29–39.
  24. Avellon A, Morago L, Garcia-Galera Del Carmen M, Munoz M, Echevarría JM. Comparative sensitivity of commercial tests for hepatitis E genotype 3 virus antibody detection. J Med Virol. 2015;87:1934–1939.
  25. Bura M, Bukowska A, Bura A, Michalak M, Mozer-Lisewska I. Hepatitis E virus antibodies in HIV-infected patients and blood donors from western Poland: A preliminary report. Adv Clin Exp Med. 2017;26:577–579.
  26. Khudyakov Y, Kamili S. Serological diagnostics of hepatitis E virus infection. Virus Res. 2011;161:84–92.
  27. Hunter JG, Madden RG, Stone AM, et al. Coastal clustering of HEV; Cornwall, UK. Eur J Gastroenterol Hepatol. 2016;28:323–327.
  28. Mansuy JM, Gallian P, Dimeglio C, et al. A nationwide survey of hepatitis E viral infection in French blood donors. Hepatology. 2016;63:1145–1154.
  29. Larska M, Krzysiak MK, Jabłoński A, Kęsik J, Bednarski M, Rola J. Hepatitis E virus antibody prevalence in wildlife in Poland. Zoonoses Public Health. 2014;62:105–110.
  30. Bura M, Mozer-Lisewska I. Quo vadis, HAV? Hepatologia. 2016;16:17–24.