Absence of occult Hepatitis E virus infection among HIV immunosuppressed patients

Martinez-Dueñas, Loreto; Martínez-Peinado, Antonio; Camacho, Ángela; Cifuentes, Celia; Gordon, Ana; Frías, Mario; Torre‐Cisneros, Julián; Pineda, Juan A.; Rivero‐Juárez, Antonio

doi:10.1016/j.jinf.2014.11.010

Cited by 10 publications

(10 citation statements)

References 9 publications

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“…Most of the studies investigating HEV viremia have been conducted among smaller-sized samples of HIV-infected patients presenting either elevated liver enzymes, low CD4+ cell counts (<200 cells/mm 3 ), or chronic liver disease. In such studies, the frequency of HEV RNA detection has varied from 0 to 4% (Crum-Cianflone et al, 2012;Hassing et al, 2014;Kaba et al, 2011;Keane et al, 2012;Merchante et al, 2015;Pischke et al, 2015;Rivero-Juarez et al, 2015;Sellier et al, 2011;Sherman et al, 2014). In the present study, eight (2.2%) out of the 360 HIV-infected patients had HEV RNA detectable by qRT-PCR; however, none of the serum samples obtained previously and subsequently remained positive, thereby excluding chronic infection.…”

Section: Discussioncontrasting

confidence: 50%

“…Moreover, none of the serum samples obtained previously and subsequently had a positive result, thereby excluding chronic infection. Studies assessing HIV-infected patients have detected chronic hepatitis in approximately one-third of the viremic cases (Crum-Cianflone et al, 2012;Kaba et al, 2011;Kuniholm et al, 2016;Merchante et al, 2015;Rivero-Juarez et al, 2015;Sellier et al, 2011), mostly associated with severe immunodeficiency (CD4+ cell counts lower than 200 cells/mm 3 ) (Dalton et al, 2009;Debes et al, 2016;Kaba et al, 2011;Kuniholm et al, 2016;Merchante et al, 2015). In the present study, the population assessed had a significant previous immunosuppression history (mean nadir CD4+ cell count <200 cells/mm 3 ); however, at the time of recruitment, the mean CD4+ cell count was higher than 500 cells/mm 3 .…”

Section: Discussionmentioning

confidence: 51%

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Detection and characterization of hepatitis E virus genotype 3 in HIV-infected patients and blood donors from southern Brazil

Silva

Oliveira

Mendoza-Sassi

et al. 2019

International Journal of Infectious Diseases

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Background: Hepatitis E virus genotype 3 (HEV-3) infection usually causes self-limited acute hepatitis. In immunosuppressed patients, HEV-3 infection can rapidly progress to chronic hepatitis and cirrhosis. In southern Brazil, data on HEV seroprevalence are scarce. Methods: Testing for HEV RNA and antibodies (anti-HEV) was performed for 320 HIV-infected patients followed at the HIV/AIDS Service of the Federal University of Rio Grande between 2012 and 2013, as well as 281 blood donor samples obtained in 2015. Variables associated with anti-HEV positivity were assessed by multivariable logistic regression analysis. Results: HIV and blood donor groups showed similar HEV seroprevalence (6.7% and 7.1%, respectively). Risk factors associated with anti-HEV detection were older age, marital status, a higher number of sexual partners, poor sanitation, and alcohol use (HIV group), and living in a rural area (blood donors). HEV RNA was detected in eight serum samples from HIV-infected patients and in one blood donor, who was also positive for anti-HEV IgM and IgG. Conclusions: The prevalence rates of HEV infection were comparable between HIV-seropositive patients who were not severely immunocompromised and blood donors. The blood donor's HEV isolate showed high similarity with swine HEV strains from Brazilian herds in the same region, thus indicating a potential risk of foodborne and parenteral transmission via blood transfusion.

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Section: Discussioncontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 51%

Detection and characterization of hepatitis E virus genotype 3 in HIV-infected patients and blood donors from southern Brazil

Silva

Oliveira

Mendoza-Sassi

et al. 2019

International Journal of Infectious Diseases

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“…Several moderately sized (n 5 93-231) European (18,(35)(36)(37)(38) and U.S. (39) studies did not detect any HEV viremia in HIV 1 patient populations. Other moderately sized (n 5 115-735) European (40)(41)(42)(43) and U.S. (44) studies detected HEV viremia in 1 or 2 patients. The current investigation was 4 times larger than previous studies, so identification of more participant samples with prevalent HEV viremia (3 vs. 2, 1, or 0 in previous studies) is not surprising, even if actual HEV incidence rates vary by geography and/or other factors.…”

Section: Discussionmentioning

confidence: 95%

“…The current study avoided testing algorithms based on HEV serology. In some previous studies, every HIV 1 patient sample was tested for HEV RNA, (18,(35)(36)(37)43) but in most studies HEV-RNA testing was limited to samples with specific serological profiles (e.g., HEV IgM 1 and/or HEV IgG 1 ). However, testing algorithms based on HEV serology may be problematic because appearance of HEV IgG/IgM antibodies post-HEV infection can be delayed or absent in immune suppressed individuals, including in HIV 1 individuals.…”

Section: Discussionmentioning

confidence: 99%

Acute and Chronic Hepatitis E Virus Infection in Human Immunodeficiency Virus‐Infected U.S. Women

et al. 2016

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Exposure to hepatitis E virus (HEV) is common in the United States (US) but there are few data on prevalence of HEV/HIV co-infection in US populations. We tested 2,919 plasma samples collected from HIV-infected (HIV+) women and men enrolled in US cohort studies for HEV viremia using a high-throughput nucleic acid testing (NAT) platform. NAT+ samples were confirmed by real-time polymerase chain reaction (PCR). Samples were selected for testing primarily on the basis of biomarkers of liver disease and immune suppression. Prevalence of HEV viremia was 3/2,606 and 0/313 in tested plasma samples collected from HIV+ women and men, respectively. All HEV isolates were genotype 3a. Based on follow-up testing of stored samples, one woman had chronic HEV infection for >4 years while 2 women had acute HEV detectable at only a single study visit. Conclusion To our knowledge this is the first reported case of chronic HEV infection in an HIV+ US individual. We also confirm that chronic HEV infection can persist despite a CD4+ count >200 cells/mm3. These data suggest that HEV infection is rare in the HIV+ US population.

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“…The cut‐off value was >1.1. This protocol was used with all patients, regardless of total CD4+ cell count, in accordance with a previous report (Rivero‐Juarez et al., ).…”

Section: Methodsmentioning

confidence: 99%

Rural habitat as risk factor for hepatitis E virus seroconversion in HIV‐infected patients: A prospective longitudinal study

Rivero‐Juárez

Cuenca-López

Martínez-Peinado

et al. 2017

Zoonoses and Public Health

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Our objective was to determine the incidence and clinical manifestations of acute hepatitis E virus (HEV) in HIV-infected patients. A prospective longitudinal study including HIV-infected HEV-seronegative patients was conducted; HEV seroconversion (to IgG and/or IgM) was the main outcome variable. All patients were tested for HEV antibodies every 3-6 months. For patients who developed HEV seroconversion, a data collection protocol was followed to identify associated clinical manifestations and analytical alterations. A total of 627 patients (89.9%) were followed during a median of 11.96 months (IQR: 8.52-14.52 months) and formed the study population. Forty-one patients developed detectable anti-HEV antibodies (7.2 cases per 100 patients/year). Our study found a high incidence of HEV in HIV-infected patients in southern Spain strongly associated with a rural habitat.

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Absence of occult Hepatitis E virus infection among HIV immunosuppressed patients

Cited by 10 publications

References 9 publications

Detection and characterization of hepatitis E virus genotype 3 in HIV-infected patients and blood donors from southern Brazil

Detection and characterization of hepatitis E virus genotype 3 in HIV-infected patients and blood donors from southern Brazil

Acute and Chronic Hepatitis E Virus Infection in Human Immunodeficiency Virus‐Infected U.S. Women

Rural habitat as risk factor for hepatitis E virus seroconversion in HIV‐infected patients: A prospective longitudinal study

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