Hepatitis E Virus Infection in HIV-infected Persons

Crum-Cianflone, Nancy F.; Curry, Jennifer A.; Drobeniuc, Jan; Weintrob, Amy; Landrum, Michael L.; Ganesan, Anuradha; Bradley, William P.; Agan, Brian K.; Kamili, Saleem

doi:10.3201/eid1803.111278

Cited by 66 publications

(44 citation statements)

References 15 publications

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“…A serologic study of samples from U.S. military personnel and their families found that HEV seropositivity in HIV-positive persons was associated with a lower CD4 ϩ cell count and higher HIV viral load, independent of antiretroviral drug use (303). A cohort of Swiss HIV patients were more likely to have chronic HEV infections if their CD4 ϩ cell counts were low (273), but a study in France, which also detected a chronic HEV case with low CD4 ϩ levels, suggested that overall anti-HEV IgG seropositivity was unrelated to CD4 ϩ cell count (272).…”

Section: Immunosuppression and Impaired Viral Clearancementioning

confidence: 99%

“…More recent studies focusing on detection of anti-HEV IgM, IgG, or RNA have identified both acute (266,(303)(304)(305)(306)(307)(308)(309)(310)(311)(312)(313) and chronic (266,(268)(269)(270)(271)(272)(273)(274) HEV infections in HIV-positive patients, though it remains unclear whether or not seroprevalence is any greater in people with HIV (272,273,300,309,310,(314)(315)(316)(317)(318). Chronic HEV infections in HIV-positive individuals have been associated with quick progression to cirrhosis (269)(270)(271), though it is not clear whether HEV-linked cryptogenic cirrhosis is more common in HIV-infected individuals than in the general population (310,311,315,319).…”

Section: Immunosuppression and Impaired Viral Clearancementioning

confidence: 99%

See 1 more Smart Citation

Host Immune Status and Response to Hepatitis E Virus Infection

2014

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SUMMARY Hepatitis E virus (HEV), identified over 30 years ago, remains a serious threat to life, health, and productivity in developing countries where access to clean water is limited. Recognition that HEV also circulates as a zoonotic and food-borne pathogen in developed countries is more recent. Even without treatment, most cases of HEV-related acute viral hepatitis (with or without jaundice) resolve within 1 to 2 months. However, HEV sometimes leads to acute liver failure, chronic infection, or extrahepatic symptoms. The mechanisms of pathogenesis appear to be substantially immune mediated. This review covers the epidemiology of HEV infection worldwide, the humoral and cellular immune responses to HEV, and the persistence and protection of antibodies produced in response to both natural infection and vaccines. We focus on the contributions of altered immune states (associated with pregnancy, human immunodeficiency virus [HIV], and immunosuppressive agents used in cancer and transplant medicine) to the elevated risks of chronic infection (in immunosuppressed/immunocompromised patients) and acute liver failure and mortality (among pregnant women). We conclude by discussing outstanding questions about the immune response to HEV and interactions with hormones and comorbid conditions. These questions take on heightened importance now that a vaccine is available.

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Section: Immunosuppression and Impaired Viral Clearancementioning

confidence: 99%

Section: Immunosuppression and Impaired Viral Clearancementioning

confidence: 99%

Host Immune Status and Response to Hepatitis E Virus Infection

2014

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“…Regarding HEV, it is an emerging cause of autochthonous hepatitis in Europe (14) and a new causative agent of acute and chronic hepatitis in HIV-infected persons (15)(16)(17)(18)(19). Nonetheless, HEV seroprevalence has not been found to date to differ statistically significantly between HIV-seropositive and -seronegative patients reference to GenBank sequence accession no.…”

mentioning

confidence: 99%

Hepatitis B and E Co-Primary Infections in an HIV-1-Infected Patient

et al. 2013

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We report an autochthonous hepatitis E virus (HEV)-hepatitis B virus co-primary infection in a 41-year-old man having sex with men and infected with human immunodeficiency virus (HIV). This case prompts testing for HEV in HIV-infected patients with acute hepatitis even if primary infection with another hepatitis virus is diagnosed. CASE REPORTA 41-year-old man having sex with men (MSM) diagnosed in 1997 with human immunodeficiency virus type 1 (HIV-1) infection (1) presented asthenia, abdominal pain, and dark urine specimens in September 2010. His CD4 ϩ T-lymphocyte count (CD4 count) was 222/mm 3 , and his plasma HIV-1 RNA level was

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“…However, HEV co-infection in patients with HIV is not common and, to date, less than 20 cases have been documented in the literature, and only a handful have had chronic infection, the majority of these cases become cleared of HEV spontaneously. 4,[62][63][64][65][66][67][68][69][70][71][72] In contrast to recipients of a SOT, the key risk factor that determines the development of chronic infection in HIV patients is a low CD4 count. In the five chronic cases described so far, all had CD4 counts <250 mm 3 .…”

Section: Hev Infection In Hiv Patientsmentioning

confidence: 99%

“…[62][63][64][65][66][73][74][75][76][77] One study retrospectively tested for HEV in 194 HIV-positive US military beneficiaries and showed that HEV was the cause of abnormal liver function tests in only 4% of HIV-infected individuals. 65 Serum transaminitis caused by HEV was no more common in this population than in the general population.…”

Section: Hev Infection In Hiv Patientsmentioning

confidence: 99%