Serological and Molecular Evidence of Hepatitis E Infection among Patients with Suspected Viral Hepatitis Seen at Korle-Bu Teaching Hospital, Accra

Abstract

Aim: Ghana is not clearly demarcated in the endemic region for hepatitis E virus but serological studies have shown a high anti-HEV seroprevalence among pregnant women in Accra, Ghana.  In this study, we investigated to assess the HEV seroprevalence in patients presenting with symptoms of hepatotropic virus at the Korle-Bu Teaching Hospital. Study Design: Structured questionnaire was administered to each consenting patient with suspected viral hepatitis to document their demographic characteristics as well as diagnosis. Place and Duration of Study: The investigations were done between between April 2010 and March 2011 at the Korle-Bu Teaching Hospital in Accra, Ghana. Methods: We obtained 17 patients blood samples and 86 archival blood samples that had previously tested negative for HBV and HCV to determine the seropositivity and seroprevalence of HEV (IgG and IgM). Information was obtained from subjects using structured questionnaire. We measured anti-HEV using enzyme-linked immunosorbent assay (ELISA) kit. HEV antigen from positive samples was measured by reverse transcription polymerase chain reaction (RT-PCR). Results: The overall serological prevalence of anti-HEV specific antibodies was low. Of the 103 serum samples tested, only 6 were positive for anti-HEV specific antibodies which gave a seroprevalence of 5.8%. Fifty percent of the ELISA seropositive samples were confirmed to be positive for HEV RNA by real time RT-PCR. All the confirmed positives were from females, 1 of whom was pregnant. Conclusions: Evidence from this study points to hepatitis E virus as one of the causes of viral hepatitis among patients seen at the Korle-Bu Teaching Hospital in Accra, Ghana suggesting that HEV remains an under-recognized and significant public health problem that needs further attention and research.