Cirrhosis, liver transplantation and HIV infection are risk factors associated with hepatitis E virus infection
M Riveiro-Barciela, M Buti, M Homs, I Campos-Varela… - PloS one, 2014 - journals.plos.org
M Riveiro-Barciela, M Buti, M Homs, I Campos-Varela, C Cantarell, M Crespo, L Castells…
PloS one, 2014•journals.plos.orgBackground Acute and chronic hepatitis E have been associated with high mortality and
development of cirrhosis, particularly in solid-organ recipients and patients infected by
human immunodeficiency virus. However, data regarding the epidemiology of hepatitis E in
special populations is still limited. Aims Investigate seroprevalence and possible factors
associated with HEV infection in a large cohort of immunosuppressed patients. Methods
Cross-sectional study testing IgG anti-HEV in serum samples from 1373 consecutive …
development of cirrhosis, particularly in solid-organ recipients and patients infected by
human immunodeficiency virus. However, data regarding the epidemiology of hepatitis E in
special populations is still limited. Aims Investigate seroprevalence and possible factors
associated with HEV infection in a large cohort of immunosuppressed patients. Methods
Cross-sectional study testing IgG anti-HEV in serum samples from 1373 consecutive …
Background
Acute and chronic hepatitis E have been associated with high mortality and development of cirrhosis, particularly in solid-organ recipients and patients infected by human immunodeficiency virus. However, data regarding the epidemiology of hepatitis E in special populations is still limited.
Aims
Investigate seroprevalence and possible factors associated with HEV infection in a large cohort of immunosuppressed patients.
Methods
Cross-sectional study testing IgG anti-HEV in serum samples from 1373 consecutive individuals: 332 liver-transplant, 296 kidney-transplant, 6 dual organ recipients, 301 non-transplanted patients with chronic liver disease, 238 HIV-infected patients and 200 healthy controls.
Results
IgG anti-HEV was detected in 3.5% controls, 3.7% kidney recipients, 7.4% liver transplant without cirrhosis and 32.1% patients who developed post-transplant cirrhosis (p<0.01). In patients with chronic liver disease, IgG anti-HEV was also statistically higher in those with liver cirrhosis (2% vs 17.5%, p<0.01). HIV-infected patients showed an IgG anti-HEV rate of 9.2%, higher than those patients without HIV infection (p<0.03). Multivariate analysis showed that the factors independently associated with anti-HEV detection were liver cirrhosis, liver transplantation and HIV infection (OR: 7.6, 3.1 and 2.4). HCV infection was a protective factor for HEV infection (OR: 0.4).
Conclusions
HEV seroprevalence was high in liver transplant recipients, particularly those with liver cirrhosis. The difference in anti-HEV prevalence between Liver and Kidney transplanted cases suggests an association with advanced liver disease. Further research is needed to ascertain whether cirrhosis is a predisposing factor for HEV infection or whether HEV infection may play a role in the pathogeneses of cirrhosis.
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