HEPATITIS-E IN SOUTH-AFRICA - EVIDENCE FOR SPORADIC SPREAD AND INCREASED SEROPREVALENCE IN RURAL-AREAS

Hepatitis E virus (HEV) is a major cause of non-A, non-B hepatitis in developing countries. Factors influencing sporadic spread of hepatitis E are unclear. We examined anti-HEV seroprevalence and demographic da ta from 407 urban and 360 rural black South African adults living in f ormal housing, squatter camps, or mud huts. Anti-HEV seroprevalence ra nged from 5.8% to 19.1% (mean 10.7%) in the different regions. Mean ur ban and rural rates were 6.6% and 15.3%, respectively (P = 0.0001). Ru ral mud hut dwellers, using unchlorinated river water, were at greater risk (17.4%) than rural villagers (5.3%; P = 0.008). A linear relatio n was found between seroprevalence and age, suggesting sporadic spread . The high prevalence in mud hut dwellers suggests that contaminated w ater plays a major role in HEV spread in South Africa. Routine chlorin ation or boiling of river drinking water before consumption may reduce HEV infection. (C) 1996 Wiley-Liss, Inc.