{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T01:03:31Z","timestamp":1783040611503,"version":"3.54.6"},"reference-count":61,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T00:00:00Z","timestamp":1686182400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Science Fund of Bulgaria","award":["KP-06-N33\/2"],"award-info":[{"award-number":["KP-06-N33\/2"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>The prevalence of hepatitis E virus (HEV) in the Bulgarian population remains underestimated. The aim of the present study was to evaluate age and gender trends in HEV prevalence in the heterogeneous Bulgarian population. Stored serum samples from blood donors and different patient sub-populations\u2014kidney recipients (KR), patients with Guillain\u2013Barre syndrome (GBS), Lyme disease (LD), patients with liver involvement and a clinical diagnosis other than viral hepatitis A and E (non-AE), hemodialysis (HD) and HIV-positive patients (HIV)\u2014were retrospectively investigated for markers of past and recent\/ongoing HEV infection. The estimated overall seroprevalence of past infection was 10.6%, ranging from 5.9% to 24.5% for the sub-populations evaluated, while the seroprevalence of recent\/ongoing HEV infection was 7.5%, ranging from 2.1% to 20.4%. The analysis of the individual sub-populations showed a different prevalence with respect to sex. In regard to age, the cohort effect was preserved, as a multimodal pattern was observed only for the GBS sub-population. Molecular analysis revealed HEV 3f and 3e. The type of the population is one of the main factors on which the anti-HEV prevalence depends, highlighting the need for the development of guidelines related to the detection and diagnosis of HEV infection with regard to specific patient populations.<\/jats:p>","DOI":"10.3390\/life13061345","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T02:02:28Z","timestamp":1686189748000},"page":"1345","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Age and Gender Trends in the Prevalence of Markers for Hepatitis E Virus Exposure in the Heterogeneous Bulgarian Population"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3462-866X","authenticated-orcid":false,"given":"Elitsa","family":"Golkocheva-Markova","sequence":"first","affiliation":[{"name":"NRL Hepatitis Viruses, Department of Virology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiydem","family":"Ismailova","sequence":"additional","affiliation":[{"name":"NRL Hepatitis Viruses, Department of Virology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ani","family":"Kevorkyan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University, 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6417-5681","authenticated-orcid":false,"given":"Ralitsa","family":"Raycheva","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Public Health, Faculty of Public Health, Medical University, 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sashka","family":"Zhelyazkova","sequence":"additional","affiliation":[{"name":"Clinic of Nervous Diseases, University Hospital \u201cAlexandrovska\u201d, Medical University, 1431 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8201-0242","authenticated-orcid":false,"given":"Stanislav","family":"Kotsev","sequence":"additional","affiliation":[{"name":"Department Infectious Diseases, Regional Hospital, 4400 Pazardzhik, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6792-9146","authenticated-orcid":false,"given":"Maria","family":"Pishmisheva","sequence":"additional","affiliation":[{"name":"Department Infectious Diseases, Regional Hospital, 4400 Pazardzhik, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9270-5996","authenticated-orcid":false,"given":"Vanya","family":"Rangelova","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University, 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6219-8524","authenticated-orcid":false,"given":"Asya","family":"Stoyanova","sequence":"additional","affiliation":[{"name":"NRL Enteroviruses, Department of Virology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viliana","family":"Yoncheva","sequence":"additional","affiliation":[{"name":"NRL Hepatitis Viruses, Department of Virology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tencho","family":"Tenev","sequence":"additional","affiliation":[{"name":"NRL Hepatitis Viruses, Department of Virology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodora","family":"Gladnishka","sequence":"additional","affiliation":[{"name":"NRL of Vector-Borne Infections, Listeria and Leptospires, Department of Microbiology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7320-9548","authenticated-orcid":false,"given":"Iva","family":"Trifonova","sequence":"additional","affiliation":[{"name":"NRL of Vector-Borne Infections, Listeria and Leptospires, Department of Microbiology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iva","family":"Christova","sequence":"additional","affiliation":[{"name":"NRL of Vector-Borne Infections, Listeria and Leptospires, Department of Microbiology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roumen","family":"Dimitrov","sequence":"additional","affiliation":[{"name":"Institute of Mathematics and Informatics, Bulgarian Academy of Sciences, 1000 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3035-5510","authenticated-orcid":false,"given":"Roberto","family":"Bruni","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna 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