To create our estimates, we modeled the annual disease burden of

To create our estimates, we modeled the annual disease burden of HEV genotypes 1 and 2 for 9 of 21 regions defined for the Global Burden of Diseases, Injuries, and Risk Factors Study (the GBD 2010 Study), which represent Panobinostat datasheet 71% of the world’s population. We estimated the seroprevalence of anti-HEV antibody and annual incidence of infection for each region using data from 37 published national studies and the DISMOD 3, a generic disease model designed for the GBD Study. We converted incident infections into three mutually exclusive results of infection: (1) asymptomatic episodes, (2) symptomatic disease, and (3) death from HEV.

We also estimated incremental cases of stillbirths among infected pregnant women. For 2005, we estimated 20.1 (95% credible interval [Cr.I.]: 2.8-37.0) million incident HEV infections across the nine GBD Regions, resulting in 3.4 (95% Cr.I.: 0.5-6.5) million symptomatic cases, 70,000 (95% Cr.I.: 12,400-132,732) deaths, and 3,000 (95% Cr.I.: 1,892-4,424) stillbirths. We estimated a probability of symptomatic illness given infection of 0.198 (95% Cr.I.: 0.167-0.229) and a probability of death given symptomatic illness of 0.019 (95% Alisertib manufacturer Cr.I.: 0.017-0.021) for nonpregnant

cases and 0.198 (95% Cr.I.: 0.169-0.227) for pregnant cases. Conclusion: The model was most sensitive to estimates of age-specific incidence of HEV disease. (HEPATOLOGY 2012) The hepatitis E virus (HEV) is an enterically transmitted RNA virus that can cause outbreaks or sporadic disease.1 HEV was first postulated as a unique infectious agent following a large outbreak of hepatitis in Kashmir in 1978, and was first isolated in the stool of Soviet military recruits stationed in Afghanistan in 1983.2, 3 HEV outbreaks Wilson disease protein are thought to result primarily from contamination of water supplies, although some evidence exists for person-to-person transmission.4 The prevalence of HEV infection varies genotypically by global region. HEV has one serotype and four reported

genotypes. Genotypes 1 and 2 exclusively infect humans and are often associated with large outbreaks and epidemics in developing countries with poor sanitation conditions. Genotypes 3 and 4 infect humans, pigs, and other animal species and have been responsible for sporadic cases of disease in developed and developing countries.5 Although genotype 3 has been reported to cause chronic hepatitis in persons with chronic liver disease, those infected with human immunodeficiency virus (HIV), or organ transplant recipients, the extent to which genotype 3 and 4 infections result in disease in otherwise healthy patients is unknown and warrants further investigation.6-11 Like hepatitis A virus infection, only a portion of those infected with HEV develop symptoms and the risk of symptomatic illness may depend on age of infection.

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