Heterogeneity in the seroprevalence of hepatitis E virus among hospital attendees: a retrospective study in Shanghai, China

BACKGROUND: Hepatitis E virus (HEV) infection is endemic in China. However, there are scarce data of HEV infection among hospital attendees seeking medical treatment or examination for various reasons. OBJECTIVE: We aim to investigate the prevalence and incidence of HEV infection by time, age, sex, and across departments in a tertiary hospital. METHODS: Paired results of anti-HEV immunoglobulin G (IgG) and IgM of 31,181 unique subjects during 2021-2022 were analysed. RESULTS: Overall seropositivity (95% confidence interval) of anti-HEV IgG and IgM was 41.25% (40.71%-41.80%) and 2.35% (2.19%-2.53%), respectively. Acute hepatitis E was more prevalent during winter-early spring and among adults aged 31-70. Anti-HEV IgG seroprevalence increased with age, levelling off at > 60 years of age. Not only the seropositivity, but also the levels of anti-HEV IgG were significantly lower in women than men of middle and old age. Young patients from the Department of Neurology had a significantly higher ratio of past HEV infection, while patients with manifestations of hepatitis, gastrointestinal symptoms or hematological diseases had higher seropositivity of anti-HEVIgM and should have high priority to HEV screening. CONCLUSION: Heterogeneity of HEV seroprevalence was noted at different times of the year, between sexes, among age groups and across departments in general hospital. The concentration of HEV-infected patients in a few departments supports a more focused screening strategy in health-care settings.