BMC infectious diseases · 2026
Multi-dimensional surveillance of hepatitis E: a 20-year observational analysis in Shanghai, China.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Chen Kaiyun, Wang Wei, Shen Xin, Xu Di, Lee Yanting, Teng Zheng, Zhang Jiming, Ren Hong, Lu Yihan
Аннотация
BACKGROUND: Hepatitis E virus (HEV) remains a major public health concern in China, with a significant increase in notified incidence over the last two decades. We aimed to examine trends and potential contributing factors associated with hepatitis E incidence and infection in Shanghai, a highly developed metropolis.
METHODS: Hepatitis E notified incidence data were retrieved from the National Notifiable Infectious Disease Reporting System (2004-2024). Six cross-sectional community-based serological surveys were conducted between 2001 and 2024, involving a total of 6,305 participants. Pathogen surveillance was annually conducted in confirmed cases, swine bile, and shellfish between 2018 and 2024. HEV was genotyped via amplification of a 150-nt fragment within ORF2 and phylogenetically analyzed.
RESULTS: A total of 14,071 hepatitis E cases were notified in Shanghai during 2004-2024, with a Joinpoint detected in 2012 and an increasing trend thereafter (annual percentage change 5.03%, p = 0.044). In serological surveys, the age-standardized anti-HEV IgG positivity rate ranged between 18.56% and 34.43% among 6,305 participants. The exploratory ratio of notified clinical cases to estimated asymptomatic infections (clinical-to-asymptomatic ratio, C/A ratio) increased most markedly in the 1961-1970 birth cohort between 2010 and 2020. Moreover, 548 of 1,367 cases and 126 of 3,900 swine bile samples tested positive for HEV RNA; none of 724 shellfish samples were positive. HEV genotype 4 accounted for 97.35% of cases, and eight genotype 3 sequences were isolated.
CONCLUSIONS: HEV infection remained common in both humans and swine in Shanghai. A comprehensive control strategy may be essential for achieving hepatitis E elimination, especially by identifying high-risk populations to reduce the burden of clinically apparent hepatitis E, in addition to routine HEV surveillance.
METHODS: Hepatitis E notified incidence data were retrieved from the National Notifiable Infectious Disease Reporting System (2004-2024). Six cross-sectional community-based serological surveys were conducted between 2001 and 2024, involving a total of 6,305 participants. Pathogen surveillance was annually conducted in confirmed cases, swine bile, and shellfish between 2018 and 2024. HEV was genotyped via amplification of a 150-nt fragment within ORF2 and phylogenetically analyzed.
RESULTS: A total of 14,071 hepatitis E cases were notified in Shanghai during 2004-2024, with a Joinpoint detected in 2012 and an increasing trend thereafter (annual percentage change 5.03%, p = 0.044). In serological surveys, the age-standardized anti-HEV IgG positivity rate ranged between 18.56% and 34.43% among 6,305 participants. The exploratory ratio of notified clinical cases to estimated asymptomatic infections (clinical-to-asymptomatic ratio, C/A ratio) increased most markedly in the 1961-1970 birth cohort between 2010 and 2020. Moreover, 548 of 1,367 cases and 126 of 3,900 swine bile samples tested positive for HEV RNA; none of 724 shellfish samples were positive. HEV genotype 4 accounted for 97.35% of cases, and eight genotype 3 sequences were isolated.
CONCLUSIONS: HEV infection remained common in both humans and swine in Shanghai. A comprehensive control strategy may be essential for achieving hepatitis E elimination, especially by identifying high-risk populations to reduce the burden of clinically apparent hepatitis E, in addition to routine HEV surveillance.