[PubMed] [Google Scholar] 18. heterogeneity level was I2= 98%; and species are isolated from humans, pigs, deer, mongeese, rabbits, wild Desoxyrhaponticin boars and camels; is usually isolated from chicken; is usually isolated from rats, Asian musk shrews, ferrets, greater bandicoots, and minks; and is Desoxyrhaponticin isolated from bats.11,13 Species A contains eight genotypes (and are obligate human pathogens.15,16 are endemic in several animal species, causing zoonotic infections in humans.15,16 Genotypes and appear to be restricted to wild boars, and genotypes and have been isolated from dromedary and Bactrian camels.15,16 In addition, a case of has been reported in a human.17 The incubation period of HEV ranges from 2 to 10 weeks.2 Symptoms of HEV infection include anorexia, fever, jaundice, myalgia, abdominal pain, back pain, rash, arthralgia, nausea, and vomiting.2,3,18 HEV infection is not clinically distinguishable from other types of acute viral hepatitis.2 HEV infection is responsible for 30% to 70% cases of acute sporadic hepatitis,19 and is one of the major causes of acute liver failure.20 HEV is mainly transmitted through the fecal-oral route due to contaminated drinking water,9,21 and zoonotic transmission.21 Foodborne transmission has also been documented.22 Other uncommon routes of HEV transmission have been documented such as vertical transmission,7 and blood-borne transmission.23-25 HEV can be diagnosed by detecting anti-HEV antibodies (IgM and IgG) or RNA-based tests for the detection of HEV RNA in biological specimens such as liver biopsy, serum, and stool.26,27 In the past two decades, two recombinant vaccines have been developed by GlaxoSmithKline (Belgium)28 and Xiamen Desoxyrhaponticin Innovax Biotech (China).29 The only licensed vaccine, HEV 239 Hecolin, has been approved by China but is not yet available commercially.30,31 To reduce the number of cases of acute and chronic HEV infection, improvements in preventive measures and control strategies have to be made.32 This meta-analysis aimed to scrutinize the burden and pooled prevalence of HEV IgG antibody in pregnant women around the world to inform researchers and policymakers. SUBJECTS AND METHODS Study protocol During December 2018 and January 2019, we performed a systematic search of the published literature on HEV contamination in pregnant women. Well-defined and clear criteria were set before conducting the search. This study was conducted according to the proposed protocol following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA),33 so that all the actions were conducted independently by two investigators and discrepancies were discussed and resolved by the third investigator. Study selection Observational studies published in 2015 to 2018 on HEV contamination in pregnant women around the world were included in this study.34 Only articles published in the English language were included. There was no age nor area restriction. Excluded were reviews, duplicate, book chapters, and other irrelevant studies. Studies with human immunodeficiency computer virus (HIV) patients or with co-infections, and studies whose required seroprevalence data were not accessible even after a request to the authors were also excluded. The search was carried out by two investigators (TA, THM) independently on PubMed and ScienceDirect. The following keywords; Hepatitis E computer virus AND pregnant women OR pregnancy were used (Table 1). We also reviewed and searched the relevant articles from the selected studies manually. Table 1. Search terms and history for studies on hepatitis E computer virus contamination in pregnant women. We also performed a sensitivity analysis by removing one study with a large sample size.51 The overall HEV IgG antibody pooled rate was 17% (95% CI: 0.11-0.25), with I 2=98%, P.01 (Additional file 1: Figure S4 and ?S5S5). Open in a separate window Physique 8. Funnel plot to assess publication bias. DISCUSSION HEV is an aged and underestimated contamination, due to inappropriate diagnosis and lack Rabbit polyclonal to NOTCH1 of awareness among physicians.52,53 In recent years, both Desoxyrhaponticin in developing and developed countries, surveillance and seroprevalence-based.
[PubMed] [Google Scholar] 18
