Bayesian estimation of hepatitis E virus seroprevalence for populations with different exposure levels to swine in The Netherlands

Martijn Bouwknegt*, B. Engel, M. M.P.T. Herremans, M. A. Widdowson, H. C. Worm, M. P.G. Koopmans, K. Frankena, A. M. De Roda Husman, M. C.M. De Jong, W. H.M. Van der Poel

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

103 Citations (Scopus)

Abstract

Hepatitis E virus (HEV) is ubiquitous in pigs worldwide and may be zoonotic. Previous HEV seroprevalence estimates for groups of people working with swine were higher than for control groups. However, discordance among results of anti-HEV assays means that true seroprevalence estimates, i.e. seroprevalence due to previous exposure to HEV, depends on choice of seroassay. We tested blood samples from three subpopulations (49 swine veterinarians, 153 non-swine veterinarians and 644 randomly selected individuals from the general population) with one IgM and two IgG ELISAs, and subsets with IgG and/or IgM Western blots. A Bayesian stochastical model was used to combine results of all assays. The model accounted for imperfection of each assay by estimating sensitivity and specificity, and accounted for dependence between serological assays. As expected, discordance among assay results occurred. Applying the model yielded seroprevalence estimates of ∼11% for swine veterinarians, ∼6% for non-swine veterinarians and ∼2% for the general population. By combining the results of five serological assays in a Bayesian stochastical model we confirmed that exposure to swine or their environment was associated with elevated HEV seroprevalence.

Original languageEnglish
Pages (from-to)567-576
Number of pages10
JournalEpidemiology and Infection
Volume136
Issue number4
Early online date20 Jun 2007
DOIs
Publication statusPublished - Apr 2008
Externally publishedYes

Bibliographical note

Cop. 2007 Cambridge University Press

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