Haffar S, et al. – The authors conducted this study to perform a meta–analysis of hepatitis E virus (HEV) seroprevalence in haemodialysis (HD) patients compared with controls. In patients on HD, HEV infection was more prevalent compared with non–haemodialysis control groups. To determine risk factors for acquisition, impact on health, and risk for chronic HEV, particularly among those patients, going to receive organ transplantation, further studies were needed.

• The authors performed a systematic search of several databases identified all observational studies with comparative arms.
• For this study, 2 reviewers extracted data and evaluated the methodological quality.
• They used a random-effects model for pooled odds ratio (OR) and 95% confidence interval (CI) of positive anti-HEV IgG in both groups.
• They evaluated heterogeneity and publication bias with appropriate tests.

• Between 1994 and 2016, the authors identified 31 studies from 17 countries.
• They judged 16 studies to have adequate quality and 15 to have moderate limitations.
• Compared with controls, HEV infection was more prevalent in patients on haemodialysis (OR 2.47, 95% CI 1.79-3.40, I² = 75.2%, P < .01).
• Several subgroup analyses were conducted without difference in results.
• Egger regression test did not suggest publication bias (P = .83).
• In patients with haemodialysis, specific risk factors for HEV transmission were not clearly identified.