High hepatitis E virus seroprevalence with absence of chronic infection in HIV-infected patients

J Infect. 2015 Jun;70(6):624-30. doi: 10.1016/j.jinf.2014.10.016. Epub 2014 Nov 5.

Abstract

Background & aims: The seroprevalence of the hepatitis E virus (HEV) and its chronicity rate in the HIV-infected population has not been well established. As a result, the magnitude of this emerging disease in this population cannot be established.

Methods: Prospective study that included HIV-infected patients followed up between September 2012 and May 2013. All included patients were tested for anti-HEV IgG/IgM. In patients with confirmed anti-HEV IgG/IgM positivity, RT-PCR was performed. In patients where HEV RNA was amplified, a second RT-PCR assay was performed 6 months later to identify transient or chronic HEV infections.

Results: Eight hundred and ninety-four HIV-infected patients were enrolled in the study. Of these patients, 399 (44.6%) were monoinfected with HIV; 462 (51.6%) were co-infected with HIV/HCV; 12 (1.3%) were co-infected with HIV/HBV; and 21 (2.3%) were co-infected with HIV/HCV/HBV. In 88 patients, anti-HEV IgG/IgM was detected (seroprevalence: 9.8% [95% CI: 8.02%-11.9%]). In five patients (0.5%; 95% CI: 0.2%-1.2%), HEV RNA was detected; 5.7% (95% CI: 2.1%-12.1%) of the patients were anti-HEV IgG/IgM positive. None of these patients showed detectable HEV RNA six months later.

Conclusion: HEV infection is frequent in HIV-infected patients but developing a chronic HEV infection may be considered an uncommon liver disease in this population.

Keywords: Anti-HEV IgG; Anti-HEV IgM; HEV RNA; HIV; Hepatitis E virus; Seroprevalence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease
  • Coinfection*
  • Female
  • HIV Infections / complications*
  • HIV Infections / immunology
  • Hepatitis Antibodies / immunology*
  • Hepatitis E / complications
  • Hepatitis E / epidemiology*
  • Hepatitis E virus / immunology*
  • Hepatitis E virus / isolation & purification
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Male
  • Middle Aged
  • Prospective Studies
  • Seroepidemiologic Studies
  • Spain / epidemiology

Substances

  • Hepatitis Antibodies
  • Immunoglobulin G
  • Immunoglobulin M