Seroprevalence of Fecal-Oral Transmitted Hepatitis A and E Virus Antibodies in Burkina Faso Kuan Abdoulaye Traore´ 1, Hortense Rouamba2, Yacouba Ne´ bie´ 3, Mahamadou Sanou3, Alfred S. Traore´ 1, Nicolas Barro1*., Pierre Roques4,5*. 1 Centre de Recherche en Sciences Biologique Alimentaire Nutritionnelles (CRSBAN), Universite´ de Ouagadougou, Ouagadougou, Burkina Faso, 2 Centre National de Transfusion Sanguine, Ouagadougou, Burkina Faso, 3 Centre me´dical de Samandin, Ouagadougou, Burkina Faso, 4 Division of Immuno-Virologie, Institute of Emerging Diseases and Innovative Therapies, Commissariat a` l’Energie Atomique (CEA), Fontenay-aux-Roses, France, 5 Unite Mixte de Recherche E1, University Paris Sud 11, Orsay, France Abstract Hepatitis A virus (HAV) and hepatitis E virus (HEV) infections occur chiefly as a result of unhygienic conditions. The purpose of this study was to assess the seroprevalence of antibodies to both viruses in central Burkina Faso in the absence of a recorded hepatitis epidemic. Serum samples from 178 blood donors (131 males and 47 females) and from 189 pregnant women were collected from November 2010 to March 2012, at blood banks and medical centers in Burkina Faso. An immunochromatography test was used to screen for Anti-HAV IgM and IgG in a subgroup of 91 blood donors and 100 pregnant women. The seroprevalence of anti-HAV IgG was 14.3% [CI95, 7.1–21.4%] for all blood donors and 23% [CI95, 14.8–31.2%] for pregnant women. Anti-HEV IgG were detected using the ELISA kits Dia.pro and Wantai and were found in 19.1% [CI95, 13.3–24.9%] of the blood donors and 11.6% [CI95, 7.1–16.2%] of the pregnant women. The seroprevalences of anti-HAV and anti-HEV IgGs did not differ significantly between men and women blood donors. Anti-HAV IgM was detected in 3.3% of the blood donors and in 2% of the pregnant women. These findings for asymptomatic individuals indicate that the HAV and HEV circulate at low but significant levels. This is the first evaluation of the acute hepatitis virus burden in Burkina Faso and the underlying epidemiologic status of the population. Citation: Traore´ KA, Rouamba H, Ne´bie´ Y, Sanou M, Traore´ AS, et al. (2012) Seroprevalence of Fecal-Oral Transmitted Hepatitis A and E Virus Antibodies in Burkina Faso. PLoS ONE 7(10): e48125. doi:10.1371/journal.pone.0048125 Editor: Laurent Re´nia, Agency for Science, Technology and Research – Singapore Immunology Network, Singapore Received January 18, 2012; Accepted September 27, 2012; Published October 22, 2012 Copyright: 2012 Traore´ et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: TKA is recipient of a thesis grant from Burkina Faso. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist. * E-mail: pierre.roques@cea.fr (PR); nicolas_barro@univ-ouaga.bf (NB) . These authors contributed equally to this work. Introduction Hepatitis A virus (HAV) and hepatitis E virus (HEV) are the leading causes of acute viral hepatitis in the world. In developing countries, these infections are associated with poor hygiene and, in particular, the lack of clean drinking water and, in some areas, inadequate sanitation [1–3]. It is estimated that 1.5 million new HAV infections occur each year and that one-third of the world’s population is infected with HEV [4]. These viruses spread by the fecal-oral route usually through contact between people [5] or by ingestion of contaminated food or water [6]. HAV belongs to the genus Hepatovirus and is a member of the Picornaviridae family [7–9]. HAV is a non-enveloped virus 27–32 nm in diameter. The viral genome is a single-stranded RNA of positive polarity, which is non-segmented and is packaged in an icosahedral capsid. HAV strains belong to a single serotype. However, there are seven viral genotypes (I–VII) and viral strains of the same genotype share greater than 85% nucleotide identity. Viruses of four of the genotypes (I, II, III and VII) have been recovered from human HAV cases, whereas viruses of the other three genotypes (IV, V and VI) have each been isolated only from a different simian species developing a hepatitis A-like illness during captivity [10,11]. HAV occurs in all countries of the world and the incidence of infection varies with the local socioeconomic conditions and health standards [9]. HAV infection is almost always clinically silent in children under three years of age but is usually symptomatic in adults and is sometimes severe. In infected individuals aged 40 years or more, the mortality rate exceeds 2% [12]. HEV was classified as a new Hepeviridae family on the basis of its structure and genome organization. The Hepevirus genus is still the only known member of this family [13]. HEV is a non-enveloped cubic-shaped virus 27–33 nm in diameter and has tooth-like projections on its surface. The viral genome consists of a single- stranded RNA of positive polarity. Four major HEV genotypes, subdivided into 24 subtypes (some being the result of recombina- tion), have been identified through classification and regional genotypic analyses [14], The different genotypes exhibit 72–77% sequence identity and there is 85–90% identity within subtypes [14,15]. Unlike other hepatitis viruses, humans are not the only natural host of this virus. Recent work shows that there are large reservoirs of HEV in various animal species, especially pigs, rabbits and ferrets, suggesting that HEV is a zoonotic agent [16,17]. HEV has an extensive global distribution, is endemic in many poor countries and causes occasional epidemics [13]. In developed countries, many of the HEV infections are imported, PLOS ONE | www.plosone.org 1 October 2012 | Volume 7 | Issue 10 | e48125