Hepatitis E virus in professionally exposed: A reason for concern?

Table 1 Occupation-related key points from meta-analyses on hepatitis E virus infection

Meta-analysis: Region/Period/No of studies	HEV IgG seroprevalence: occupational/general population	Occupation-related key points
16 countries; 1999-2018; 32 studies[37]	32.85%/21.70%	The anti-HEV IgG PR for all swine workers was 1.52 (95%CI: 1.38-1.76); butchers 1.75 (95%CI: 1.31–2.35), swine farmers 1.51 (95%CI: 1.32–1.74), meat processors 1.46 (95%CI: 1.13–1.89), veterinarians 1.36 (95%CI: 1.15–1.61) and pork retailers 1.19 (95%CI: 1.09–1.29) compared to the general population; The anti-HEV IgG PR for swine workers in Asia was 1.49 (95%CI: 1.35-1.64) and in Europe 1.93 (95%CI: 1.49-2.50)
Mainland China; 2004-2018; 28 studies[24]	47.4%/27.3%	Anti-HEV IgG positivity: Swine vendors (77.0%), producers (56.0%), swine farmers (53.0%), slaughters (51.7%) and veterinarians (43.7%); The OR for HEV IgG seropositivity in swine occupational population was 2.63 (95%CI: 1.87–3.70) compared to the general population
Europe; 2003-2015; 73 studies[51]	17%/28% using WT	Seroprevalence rates depend on the serologic assays used; increased with age, were unrelated to gender, varied within countries; Individuals in contact with swine/wild animals had higher seroprevalence rates than the general population, irrespective of assay used (P < 0.0001)
Global, non-endemic HEV countries; 1994- 2018; 163 studies[52]	Not calculated	The OR for HEV seropositivity for occupational contact with pigs was 1.95 and for the employment in forestry population 2.49 compared to the general population; Recreational hunting was a non-significant predictor for HEV seropositivity; Contact with pigs (not categorized as occupational), cats or horses was non-significantly associated, contact with dogs was significantly associated with increased odds of HEV IgG seropositivity; The consumption of meat (uncooked liver sausage, rabbit and game meat, liver or organ meats, bacon or ham, and pork) was a significant predictor of HEV IgG seropositivity (median OR = 1.44, range (1.12-2.77)

CI: Confidence interval; HEV: Hepatitis E virus; OR: Odds ratio; PR: Prevalence ratio; WT: Wantai test.