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World J Gastroenterol. Jul 7, 2019; 25(25): 3168-3182
Published online Jul 7, 2019. doi: 10.3748/wjg.v25.i25.3168
Epidemiology of hepatitis E in South-East Europe in the "One Health" concept
Anna Mrzljak, Petra Dinjar-Kujundzic, Lorena Jemersic, Jelena Prpic, Ljubo Barbic, Vladimir Savic, Vladimir Stevanovic, Tatjana Vilibic-Cavlek
Anna Mrzljak, Department of Medicine, Merkur University Hospital; School of Medicine, University of Zagreb, Zagreb 10000, Grad Zagreb, Croatia
Petra Dinjar-Kujundzic, Department of Medicine, Merkur University Hospital, Zagreb 10000, Grad Zagreb, Croatia
Lorena Jemersic, Jelena Prpic, Vladimir Savic, Croatian Veterinary Institute, Zagreb 10000, Grad Zagreb, Croatia
Ljubo Barbic, Vladimir Stevanovic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb 10000, Grad Zagreb, Croatia
Tatjana Vilibic-Cavlek, Department of Virology, Croatian Institute of Public Health; School of Medicine, University of Zagreb, Zagreb 10000, Grad Zagreb, Croatia
Author contributions: Mrzljak A and Dinjar-Kujundzic P made contributions to conception and design of the study, acquisition of the data, involved in drafting the manuscript. Jemersic L, Prpic J, Barbic L, Savic V and Stevanovic V made contributions in acquisition of the data, involved in drafting the manuscript. Vilibic-Cavlek T made contributions to design, involved in drafting and revising the manuscript critically. All authors read and approved the final manuscript.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Anna Mrzljak MD, PhD, Assistant Professor, Department of Medicine, Merkur University Hospital, Zajceva 19, Zagreb 10000, Grad Zagreb, Croatia. anna.mrzljak@mef.hr
Telephone: +385-1-2431390 Fax: +385-1-2431393
Received: March 11, 2019
Peer-review started: March 11, 2019
First decision: May 9, 2019
Revised: May 16, 2019
Accepted: May 31, 2019
Article in press: June 1, 2019
Published online: July 7, 2019
Core Tip

Core tip: In South-East Europe, the hepatitis E virus (HEV) prevalence as in other parts of Europe varies greatly, depending on the studied population, geographical area and methods used. Seroprevalence rates were found to be 0%-36% in humans and 10.3%-54.5% in animals. Human studies showed sporadic detection of HEV RNA in patients with acute hepatitis and in transplant population. HEV RNA was detected in up to 31.6% pigs and 16.7% environmental samples. Studies on phylogenetic characterization in human, animal and environmental samples showed that HEV strains from the south-eastern European countries mainly belong to the genotype 3.