{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T21:58:04Z","timestamp":1789077484261,"version":"build-2803163510"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2018,3,23]],"date-time":"2018-03-23T00:00:00Z","timestamp":1521763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 AI51\/31\/2004"],"award-info":[{"award-number":["R01 AI51\/31\/2004"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1109905"],"award-info":[{"award-number":["OPP1109905"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Hepatitis E virus (HEV) is a major cause of acute viral hepatitis in Southeast Asia. Several studies have suggested that antibody persistence after HEV infection may be transient, possibly increasing the risk of reinfection and contributing to the frequency of outbreaks in HEV-endemic regions. The specific conditions under which antibodies to HEV are lost, or \u201cseroreversion\u201d occurs, are poorly understood. Here, 100 participants from population-based studies in rural Bangladesh were revisited in 2015, 10 years after a documented HEV infection, to examine long-term antibody persistence. Twenty percent (95% confidence interval: 12.0, 28.0) of the participants no longer had detectable antibodies at follow-up, suggesting that antibodies generally persist for at least a decade after infection in rural Bangladesh. Persons who were seronegative at follow-up were generally younger at infection than those who remained positive (14.4 years vs. 33.6 years; P &amp;lt; 0.0001). This age-dependent antibody loss could partially explain cross-sectional seroprevalence data from Southeast Asia, where children have reportedly low antibody prevalence. The results of this study provide new insight into the immunological persistence of HEV infection in a micronutrient-deficient rural population of South Asia, highlighting the importance of age at infection in the ability to produce long-lasting antibodies against HEV.<\/jats:p>","DOI":"10.1093\/aje\/kwy044","type":"journal-article","created":{"date-parts":[[2018,3,19]],"date-time":"2018-03-19T20:09:39Z","timestamp":1521490179000},"page":"1501-1510","source":"Crossref","is-referenced-by-count":16,"title":["A 10-Year Immunopersistence Study of Hepatitis E Antibodies in Rural Bangladesh"],"prefix":"10.1093","volume":"187","author":[{"given":"Brittany L","family":"Kmush","sequence":"first","affiliation":[{"name":"Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalequ","family":"Zaman","sequence":"first","affiliation":[{"name":"Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Yunus","sequence":"first","affiliation":[{"name":"Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parimalendu","family":"Saha","sequence":"first","affiliation":[{"name":"Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenrad E","family":"Nelson","sequence":"first","affiliation":[{"name":"Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland"},{"name":"Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain B","family":"Labrique","sequence":"first","affiliation":[{"name":"Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland"},{"name":"Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,3,23]]},"reference":[{"issue":"4","key":"2020040203350845600_kwy044C1","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1002\/hep.25505","article-title":"The global burden of hepatitis E virus genotypes 1 and 2 in 2005","volume":"55","author":"Rein","year":"2012","journal-title":"Hepatology"},{"issue":"3","key":"2020040203350845600_kwy044C2","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.jhep.2007.12.008","article-title":"Hepatitis E: an emerging awareness of an old disease","volume":"48","author":"Purcell","year":"2008","journal-title":"J Hepatol"},{"issue":"6","key":"2020040203350845600_kwy044C3","first-page":"677","article-title":"Seroprevalence of hepatitis E infection in pregnancy\u2014more questions than answers","volume":"130","author":"Navaneethan","year":"2009","journal-title":"Indian J Med Res"},{"key":"2020040203350845600_kwy044C4","first-page":"53","volume-title":"Emerging Infections","author":"Labrique","year":"2010","edition":"9th ed"},{"issue":"5","key":"2020040203350845600_kwy044C5","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1093\/cid\/ciu371","article-title":"A systematic review of hepatitis E virus infection in children","volume":"59","author":"Verghese","year":"2014","journal-title":"Clin Infect Dis"},{"issue":"5","key":"2020040203350845600_kwy044C6","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1097\/QCO.0000000000000188","article-title":"Hepatitis A: epidemiology in resource-poor countries","volume":"28","author":"Aggarwal","year":"2015","journal-title":"Curr Opin Infect Dis"},{"issue":"8","key":"2020040203350845600_kwy044C7","doi-asserted-by":"crossref","first-page":"3428","DOI":"10.1073\/pnas.91.8.3428","article-title":"Seroepidemiology of water-borne hepatitis in India and evidence for a third enterically transmitted hepatitis agent","volume":"91","author":"Arankalle","year":"1994","journal-title":"Proc Natl Acad Sci USA"},{"issue":"1","key":"2020040203350845600_kwy044C8","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/liv.13237","article-title":"The global burden of hepatitis E outbreaks: a systematic review","volume":"37","author":"Hakim","year":"2017","journal-title":"Liver Int"},{"issue":"11","key":"2020040203350845600_kwy044C9","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1111\/jvh.12407","article-title":"An outbreak of hepatitis E in an urban area of Bangladesh","volume":"22","author":"Haque","year":"2015","journal-title":"J Viral Hepat"},{"issue":"5","key":"2020040203350845600_kwy044C10","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1093\/cid\/ciu383","article-title":"Outbreak of hepatitis E in urban Bangladesh resulting in maternal and perinatal mortality","volume":"59","author":"Gurley","year":"2014","journal-title":"Clin Infect Dis"},{"issue":"5","key":"2020040203350845600_kwy044C11","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1017\/S0950268811002925","article-title":"Fatal outbreaks of jaundice in pregnancy and the epidemic history of hepatitis E","volume":"140","author":"Teo","year":"2012","journal-title":"Epidemiol Infect"},{"issue":"3","key":"2020040203350845600_kwy044C12","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1002\/rmv.384","article-title":"Hepatitis E virus","volume":"13","author":"Emerson","year":"2003","journal-title":"Rev Med Virol"},{"issue":"1","key":"2020040203350845600_kwy044C13","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1002\/(SICI)1096-9071(199609)50:1<50::AID-JMV10>3.0.CO;2-1","article-title":"IgM and IgG antibodies to hepatitis E virus (HEV) detected by an enzyme immunoassay based on an HEV-specific artificial recombinant mosaic protein","volume":"50","author":"Favorov","year":"1996","journal-title":"J Med Virol"},{"issue":"3","key":"2020040203350845600_kwy044C14","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/S0891-5520(05)70126-4","article-title":"Hepatitis E","volume":"14","author":"Krawczynski","year":"2000","journal-title":"Infect Dis Clin North Am"},{"key":"2020040203350845600_kwy044C15","volume-title":"Janeway\u2019s Immunobiology","author":"Murphy","year":"2008","edition":"7th ed"},{"issue":"10","key":"2020040203350845600_kwy044C16","doi-asserted-by":"crossref","first-page":"e13560","DOI":"10.1371\/journal.pone.0013560","article-title":"Profile of acute infectious markers in sporadic hepatitis E","volume":"5","author":"Huang","year":"2010","journal-title":"PLoS One"},{"issue":"10","key":"2020040203350845600_kwy044C17","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1016\/j.trstmh.2005.12.005","article-title":"Hepatitis E antibody kinetics in Nepalese patients","volume":"100","author":"Myint","year":"2006","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"3","key":"2020040203350845600_kwy044C18","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1093\/infdis\/170.3.517","article-title":"Epidemic hepatitis E in Pakistan: patterns of serologic response and evidence that antibody to hepatitis E virus protects against disease","volume":"170","author":"Bryan","year":"1994","journal-title":"J Infect Dis"},{"issue":"8856","key":"2020040203350845600_kwy044C19","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1016\/0140-6736(93)90873-F","article-title":"Hepatitis E and long-term antibody status","volume":"341","author":"Khuroo","year":"1993","journal-title":"Lancet"},{"issue":"6","key":"2020040203350845600_kwy044C20","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1046\/j.1365-2893.1999.00190.x","article-title":"Retrospective serological analysis of hepatitis E patients: a long-term follow-up study","volume":"6","author":"Chadha","year":"1999","journal-title":"J Viral Hepat"},{"issue":"4","key":"2020040203350845600_kwy044C21","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1002\/jmv.1890360403","article-title":"Serologic identification of hepatitis E virus infections in epidemic and endemic settings","volume":"36","author":"Favorov","year":"1992","journal-title":"J Med Virol"},{"issue":"1","key":"2020040203350845600_kwy044C22","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1177\/004947559002000105","article-title":"Enterically transmitted non-A, non-B hepatitis associated with an outbreak in Dhaka: epidemiology and public health implications","volume":"20","author":"Hlady","year":"1990","journal-title":"Trop Doct"},{"issue":"3","key":"2020040203350845600_kwy044C23","first-page":"14","article-title":"Outbreak of hepatitis E in a low income urban community in Bangladesh","volume":"7","author":"International Center for Diarrhoeal Disease Research, Bangladesh","year":"2009","journal-title":"Health Sci Bull"},{"issue":"8","key":"2020040203350845600_kwy044C24","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1002\/jmv.23601","article-title":"Epidemiological and molecular analyses of a non-seasonal outbreak of acute icteric hepatitis E in Bangladesh","volume":"85","author":"Harun-Or-Rashid","year":"2013","journal-title":"J Med Virol"},{"issue":"4","key":"2020040203350845600_kwy044C25","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1179\/136485909X435120","article-title":"Sero-epidemiology of sporadic acute hepatitis in Bangladesh: high prevalences of infection with type-B, type-E and multiple types of hepatitis virus","volume":"103","author":"Sugitani","year":"2009","journal-title":"Ann Trop Med Parasitol"},{"issue":"5","key":"2020040203350845600_kwy044C26","doi-asserted-by":"crossref","first-page":"875","DOI":"10.4269\/ajtmh.2009.09-0352","article-title":"Population seroprevalence of hepatitis E virus antibodies in rural Bangladesh","volume":"81","author":"Labrique","year":"2009","journal-title":"Am J Trop Med Hyg"},{"issue":"8","key":"2020040203350845600_kwy044C27","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1093\/aje\/kwq225","article-title":"Epidemiology and risk factors of incident hepatitis E virus infection in rural Bangladesh","volume":"172","author":"Labrique","year":"2010","journal-title":"Am J Epidemiol"},{"issue":"5","key":"2020040203350845600_kwy044C28","doi-asserted-by":"crossref","first-page":"e61351","DOI":"10.1371\/journal.pone.0061351","article-title":"An exploratory case control study of risk factors for hepatitis E in rural Bangladesh","volume":"8","author":"Labrique","year":"2013","journal-title":"PLoS One"},{"issue":"3","key":"2020040203350845600_kwy044C29","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1002\/hep.510270331","article-title":"Evaluation of assays for antibody to hepatitis E virus by a serum panel. Hepatitis E Virus Antibody Serum Panel Evaluation Group","volume":"27","author":"Mast","year":"1998","journal-title":"Hepatology"},{"issue":"5","key":"2020040203350845600_kwy044C30","first-page":"1072","article-title":"Clinical and epidemiological relevance of quantitating hepatitis E virus-specific immunoglobulin M","volume":"9","author":"Seriwatana","year":"2002","journal-title":"Clin Diagn Lab Immunol"},{"issue":"3","key":"2020040203350845600_kwy044C31","first-page":"639","article-title":"Quantitation of immunoglobulin to hepatitis E virus by enzyme immunoassay","volume":"9","author":"Innis","year":"2002","journal-title":"Clin Diagn Lab Immunol"},{"issue":"5","key":"2020040203350845600_kwy044C32","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1002\/jmv.21656","article-title":"A comparison of two commercially available anti-HEV IgG kits and a re-evaluation of anti-HEV IgG seroprevalence data in developed countries","volume":"82","author":"Bendall","year":"2010","journal-title":"J Med Virol"},{"issue":"4","key":"2020040203350845600_kwy044C33","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.jcv.2013.10.010","article-title":"Diagnostic performance of selected commercial HEV IgM and IgG ELISAs for immunocompromised and immunocompetent patients","volume":"58","author":"Pas","year":"2013","journal-title":"J Clin Virol"},{"issue":"12","key":"2020040203350845600_kwy044C34","doi-asserted-by":"crossref","first-page":"2309","DOI":"10.3201\/eid1712.110371","article-title":"Hepatitis E virus antibodies in blood donors, France","volume":"17","author":"Mansuy","year":"2011","journal-title":"Emerg Infect Dis"},{"issue":"12","key":"2020040203350845600_kwy044C35","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.1016\/j.vaccine.2008.12.061","article-title":"Randomized-controlled phase II clinical trial of a bacterially expressed recombinant hepatitis E vaccine","volume":"27","author":"Zhang","year":"2009","journal-title":"Vaccine"},{"issue":"4","key":"2020040203350845600_kwy044C36","doi-asserted-by":"crossref","first-page":"714","DOI":"10.4269\/ajtmh.15-0159","article-title":"Two generations of \u201cgold standards\u201d: the impact of a decade in hepatitis E virus testing innovation on population seroprevalence","volume":"93","author":"Kmush","year":"2015","journal-title":"Am J Trop Med Hyg"},{"key":"2020040203350845600_kwy044C37","author":"StataCorp LLC","year":"2009"},{"issue":"7","key":"2020040203350845600_kwy044C38","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1086\/651077","article-title":"Evidence of person-to-person transmission of hepatitis E virus during a large outbreak in northern Uganda","volume":"50","author":"Teshale","year":"2010","journal-title":"Clin Infect Dis"},{"issue":"4","key":"2020040203350845600_kwy044C39","doi-asserted-by":"crossref","first-page":"647","DOI":"10.4269\/ajtmh.2011.10-0456","article-title":"Hepatitis E virus infections in swine and swine handlers in Vellore, southern India","volume":"84","author":"Vivek","year":"2011","journal-title":"Am J Trop Med Hyg"},{"issue":"7","key":"2020040203350845600_kwy044C40","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1093\/aje\/kwh090","article-title":"A modified Poisson regression approach to prospective studies with binary data","volume":"159","author":"Zou","year":"2004","journal-title":"Am J Epidemiol"},{"key":"2020040203350845600_kwy044C41","author":"Joesph","year":"2014"},{"issue":"2","key":"2020040203350845600_kwy044C42","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1093\/infdis\/171.2.447","article-title":"Age-specific prevalence of antibodies to hepatitis A and E viruses in Pune, India, 1982 and 1992","volume":"171","author":"Arankalle","year":"1995","journal-title":"J Infect Dis"},{"issue":"5","key":"2020040203350845600_kwy044C43","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1002\/rmv.1719","article-title":"Hepatitis E virus: neutralizing sites, diagnosis, and protective immunity","volume":"22","author":"Zhang","year":"2012","journal-title":"Rev Med Virol"},{"issue":"4","key":"2020040203350845600_kwy044C44","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1128\/JCM.44.4.1581-1583.2006","article-title":"Evaluation of diagnostic assays for hepatitis E virus in outbreak settings","volume":"44","author":"Myint","year":"2006","journal-title":"J Clin Microbiol"}],"container-title":["American Journal of Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/aje\/article-pdf\/187\/7\/1501\/32989848\/kwy044.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/aje\/article-pdf\/187\/7\/1501\/32989848\/kwy044.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T07:36:03Z","timestamp":1585812963000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/aje\/article\/187\/7\/1501\/4952150"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,23]]},"references-count":44,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2018,3,23]]},"published-print":{"date-parts":[[2018,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/aje\/kwy044","relation":{},"ISSN":["0002-9262","1476-6256"],"issn-type":[{"value":"0002-9262","type":"print"},{"value":"1476-6256","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2018,7]]},"published":{"date-parts":[[2018,3,23]]}}}