Seroprevalence and risk assessment of viral hepatitis E infection in a group of exposed persons from Republic of Moldova.

INTRODUCTION: Viral hepatitis E is considered to be an important issue for public health in developing countries. The aim of the present study is to evaluate morbidity and risk factors in occupationally exposed groups such as people working on sausage production. METHODOLOGY: Seroprevalence of HEV (hepatitis E virus) and risk factors to infection were determined in a cross-sectional study of two groups of populations: people working on sausage production (n = 70) and persons without occupational exposure (people working in the textile industry n = 70) in Moldova, a country without reported cases of hepatitis E. RESULTS: The seroprevalence of HEV was 14.3% (CI 95%, 13.1-15.5%) in the group of exposed, compared with no cases in the non-exposed group that indicates on no previous infectious contact with hepatitis E virus. CONCLUSIONS: The increased seroprevalence of HEV among persons with occupational exposure to swine meat suggest animal-to-human transmission of this infection.

Hepatitis B, C and D virus genotypes detected in HBsAg- or anti-HCV-positive people from the Republic of Moldova.

In the Republic of Moldova, little is known about hepatitis B, C and D virus (HBV, HCV, HDV) genotypes, although the genetic variant may influence the course and outcome of disease. For HBV genotyping, 301 hepatitis B surface antigen (HBsAg)-positive sera collected in 2010 and 2011 from drug users, prison inmates, commercial sex workers, and the general population in different geographical regions were investigated. The 31 HBsAg-positive sera collected in 2011 were also tested for HDV. Eighty-eight anti-HCV-positive sera collected between 2010 and 2011 from the general population and health care workers were used for HCV genotyping. Phylogenetic analysis of 84 HBV sequences showed that most of the viruses belonged to genotype D (n = 82, 97.6%), predominantly to the subgenotype D1/D2 cluster (n = 75/82, 91.5%). One sequence (74110) clustered as an outlier to this cluster, and six sequences belonged to subgenotype D3. Only two subgenotype A2 sequences were found. Cloning of six samples with ambiguous sequence chromatogram signals showed no mixed infections. Phylogenetic analysis of HCV sequences from 66 patients showed a predominance of subtype 1b (n = 63, 95.5%). Two sequences belonged to subtype 3a, and one to subtype 2a. HDV RNA belonging to genotype 1 was found in two sera (2/31, 6.5%). Thus, genotypes prevalent in Europe were detected for all three hepatitis viruses. For both HBV and HCV, one genotype was dominant, while occasional other variants seem to be restricted to certain cohorts and/or transmission routes.

Epidemiology of hepatitis C in the Republic of Moldova: achievements and remaining challenges in prevention and control.

Viral hepatitis, especially those with parenteral and sexual transmission, still remain a major problem of public health, both globally and for the Republic of Moldova, due to wide spreading, endemicity, increased morbidity and mortality and high rate of invalidity following the chronization of infection, but usually neglected by population and public health authorities. This paper describes the epidemiology and preventive and control measures of hepatitis C in Moldova. Epidemiological analysis of the surveillance data on hepatitis C incidence in the Republic of Moldova was conducted. The data were obtained from the national reporting system of infectious diseases and serosurvey studies. Epidemiological particularities of acute and chronic hepatitis C in general Moldovan population and specific risk groups were evaluated. National hepatitis policies for prevention and control were analyzed. Only consolidation of all the actions stipulated in the national and international normative documents on the prevention and control of hepatitis, will help to reduce the morbidity of viral hepatitis C and probably to eliminate the new cases of disease in some regions.

Epidemiology of hepatitis B virus infection in the Republic of Moldova.

BACKGROUND: The Republic of Moldova is considered a high endemic country with hepatitis B virus infection having a prevalence of AgHBs of 8% and higher. This paper describes the epidemic process and changes in the acute hepatitis B incidence in Moldova from 1966 until 2006. The objective was to evaluate the prophylactic measures that have led to the decline in the epidemic process of this infection. METHODOLOGY: Epidemiological analysis of the surveillance data on acute hepatitis B incidence in the Republic of Moldova was conducted. The data were obtained from the national reporting system of infectious diseases. RESULTS: In the course of hepatitis B virus infection evolution in the Republic of Moldova, the epidemic process had both increasing and decreasing phases; however, starting in 1989 the incidence of this infection decreased from 66.4 to 7.5 per 100,000 population in 2006. The decrease of the incidence has been most significant in children under 15 years, dropping from 80.8 to 2.0 per 100,000 population in the mentioned period. CONCLUSIONS: Data collected in the Republic of Moldova shows that vaccination against hepatitis B virus infection may be a very efficient preventive measure and may have a positive impact on reducing the morbidity of this infection.