Incidence and natural history of hepatitis E virus coinfection among HIV-infected patients

Pineda, Juan A.; Cifuentes, Celia; Parra, Manuel; Merchante, Nicolás; Pérez-Navarro, Elisabet; Rivero‐Juárez, Antonio; Monje, P.; Rivero, Antonio; Macı́as, Juan; Real, Luis Miguel

doi:10.1097/qad.0000000000000378

Cited by 48 publications

(54 citation statements)

References 24 publications

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“…Something similar was reported by other authors [270, 271]. In some studies, low CD4 + T cell counts have been associated with higher risk of HEV infection [260, 265]. Jardi et al [259] concluded that the only factor associated with HEV IgG detection among HIV patients was the presence of liver cirrhosis (23% in patients with cirrhosis versus 6% in patients without cirrhosis), suggesting that individuals with cirrhosis are at a high risk of acquiring HEV infection [259].…”

Section: Routes Of Transmission and Risk Groupssupporting

confidence: 81%

“…Jardi et al [259] concluded that the only factor associated with HEV IgG detection among HIV patients was the presence of liver cirrhosis (23% in patients with cirrhosis versus 6% in patients without cirrhosis), suggesting that individuals with cirrhosis are at a high risk of acquiring HEV infection [259]. This has also been reported by other authors [19, 260]. …”

Section: Routes Of Transmission and Risk Groupsmentioning

confidence: 64%

“…In Europe, reported seroprevalence among HIV ranges from 1% to 26% [52, 258–265] with some countries, for example, Spain, with values ranging from 9 to 26% depending on the study [52, 53, 259, 260, 266–268]. According to some authors, HIV infection seems to be a risk factor, not for acquiring an HEV infection, but for developing a chronic infection.…”

Section: Routes Of Transmission and Risk Groupsmentioning

confidence: 99%

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Hepatitis E Virus in Industrialized Countries: The Silent Threat

Clemente-Casares

Ramos-Romero

Ramirez-Gonzalez

et al. 2016

BioMed Research International

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Hepatitis E virus (HEV) is the main cause of acute viral hepatitis worldwide. Its presence in developing countries has been documented for decades. Developed countries were supposed to be virus-free and initially only imported cases were detected in those areas. However, sporadic and autochthonous cases of HEV infection have been identified and studies reveal that the virus is worldwide spread. Chronic hepatitis and multiple extrahepatic manifestations have also been associated with HEV. We review the data from European countries, where human, animal, and environmental data have been collected since the 90s. In Europe, autochthonous HEV strains were first detected in the late 90s and early 2000s. Since then, serological data have shown that the virus infects quite frequently the European population and that some species, such as pigs, wild boars, and deer, are reservoirs. HEV strains can be isolated from environmental samples and reach the food chain, as shown by the detection of the virus in mussels and in contaminated pork products as sausages or meat. All these data highlight the need of studies directed to control the sources of HEV to protect immunocompromised individuals that seem the weakest link of the HEV epidemiology in industrialized regions.

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Section: Routes Of Transmission and Risk Groupssupporting

confidence: 81%

Section: Routes Of Transmission and Risk Groupsmentioning

confidence: 64%

Section: Routes Of Transmission and Risk Groupsmentioning

confidence: 99%

See 1 more Smart Citation

Hepatitis E Virus in Industrialized Countries: The Silent Threat

Clemente-Casares

Ramos-Romero

Ramirez-Gonzalez

et al. 2016

BioMed Research International

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“…Another north/south seroprevalence gradient has been reported in the United Kingdom, where Scotland seems to have the lowest seroprevalence in Europe (less than 3%) (Cleland et al., ). In our setting, the reported HEV seroprevalence in two HIV‐infected cohorts of 21% and 27%, respectively, seems to be higher than the national rate (14.7%) (Pineda et al., ; Rivero‐Juarez et al., ). These reported seroprevalence rates correlate with the relatively high seroincidence found in our study.…”

Section: Discussionmentioning

confidence: 50%

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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“…South Spain is one of the principal European producers of pork from extensive farming (black Iberian pig) and bush meat (overall deer and wild boar), with a consumption level for individuals of wild boar ( Sus scrofa ) meat of approximately 3.5 kg/person/year. Furthermore, in this region, the reported prevalence and incidence of HEV among humans is high (Pineda et al., ; Rivero‐Juarez et al., ). Consequently, southern Spain could be considered a hot spot of HEV infection.…”

Section: Introductionmentioning

confidence: 99%

Familial Hepatitis E Outbreak Linked to Wild Boar Meat Consumption

Rivero‐Juárez

Frías

Martínez-Peinado

et al. 2017

Zoonoses and Public Health

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An HIV-infected patient was diagnosed with acute hepatitis E infection in our hospital. An epidemiological inquiry was performed to collect demographic, food and animal exposure variables in order to identify the potential route of transmission. The patient reported that his family traditionally hunted wild boar for food. All family members were analysed for hepatitis E virus infection. Additionally, route of transmission by wild boar meat consumption and prevalence of HEV infection among wild boar from the same hunting area were investigated. In all-family members (n = 8), HEV-RNA was amplified. Two wild boar meat slices consumed was analysed, showing the presence of HEV. The virus isolated was consistent with genotype 3, revealing 100% homology between family members and meat. Additionally, we tested nine wild boar hunted in the same hunting area. All of them were RNA-HEV positive, isolating the same HEV genotype 3 viral strain. We demonstrated by phylogenetic analysis zoonotic transmission of HEV by wild boar meat consumption. The prevalence of HEV infection among wild boar found in our study suggests that this species is an important route of transmission to human.

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Incidence and natural history of hepatitis E virus coinfection among HIV-infected patients

Abstract: Exposure to HEV among HIV-infected patients in Spain is very common, and this increases with age. Evolution to chronic infection is extremely unusual. Most cases of acute HEV infection seem to be clinically and biochemically unexpressive, therefore going unnoticed.

Cited by 48 publications

References 24 publications

Hepatitis E Virus in Industrialized Countries: The Silent Threat

Hepatitis E Virus in Industrialized Countries: The Silent Threat

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

Familial Hepatitis E Outbreak Linked to Wild Boar Meat Consumption

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