Background and objective:

Hepatitis E virus (HEV) infection has recognised as the most common form of acute viral hepatitis among young adults in many developing countries. However, community-based surveys on this infection are scarce. This study looks at the seroepidemiology of HEV infection in the city of Nahavand (with 72 000 inhabitants), in the western part of Iran.

Subjects and methods:

This cross-sectional study was conducted in February of 2003 among people of age 6 years and over in Nahavand. The six urban regions of Nahavand were considered as strata and 1824 subjects were recruited through a random stratified sampling (304 subjects from each stratum). Questionnaires were completed by face-to-face interview (including socio-economic and demographic variables) and blood samples were taken and tested for anti-HEV IgG using ELISA. STATA 8 was used to analyse data considering complex sampling design.

Results:

A total of 799 males (43.8%) and 1025 (56.2%) females were included (34.7 ± 19.5 and 32 years as mean ± SD and median of age, respectively). The overall seroprevalence of hepatitis E was 9.6% (95% CI: 8.2–10.9). Seropositive subjects had mean and median age of 42.6 ± 15.6 and 40.5 years, respectively. Fifty-nine of seropositive subjects (34.7%) were male, 55 of them (32.4%) were illiterate and median of their family size was 4.0 persons. The prevalence of anti-HEV IgG antibody was not equally distributed among age groups with highest rate observable in the 30–39-year-old subjects (30%). Seropositivity for anti-HEV IgG was positively associated with age (OR = 1.02;%95CI: 1.01–1.03), sex (F/M) (OR = 1.52,%95 CI: 1.09–2.11) and educational level (illiterate/literate) (OR = 1.81,%95 CI: 1.28–2.55). No association observed between family size and seropositivity [OR = 0.82,%95 CI: 0.60–1.13]. Logistic multivariate regression indicated age and sex as the only significant risk factors of seropositivity. Adjusted ORs for age and sex were 1.03 (%95 CI: 1.01–1.04) and 1.61 (%95 CI: 1.13–2.28), respectively.

Conclusions:

The high prevalence of positive serology observed in this study urges more researches in Nahavand and other regions of the country considering related risk factors. It is also important to study the relative contribution of HEV infection to the burden of acute viral hepatitis.