Increased Hepatitis E Virus Seroprevalence Correlates with Lower CD4+ Cell Counts in HIV-Infected Persons in Argentina

Debes, José D.; Wassaf, Maribel Martínez; Pisano, María Belén; Isa, Marı́a Beatrı́z; Lotto-Batista, Martín; Marianelli, L; Frassone, Natalia; Ballari, Estefania; Bohjanen, Paul R.; Hansen, Bettina E.; Ré, Viviana Elizabeth

doi:10.1371/journal.pone.0160082

Cited by 22 publications

(24 citation statements)

References 15 publications

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“…13 Cumulative exposure over time can explain that increasing age is a risk factor associated with HEV infection both in the HIV-infected and general population. 30,31 Similar to previous studies, 32 were not available in this study.…”

Section: Discussionmentioning

confidence: 59%

Hepatitis E virus infection in HIV‐infected patients: A large cohort study in Yunnan province, China

Zhou

Ren

Xia

et al. 2018

Journal of Medical Virology

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Hepatitis E virus (HEV) infection in immunocompromised patients often results in distinct outcome, compared to the infection in general population. This study aimed to investigate the prevalence, potential risk factors, and clinical features of HEV infection among HIV patients treated with antiretroviral therapy (ART) in Yunnan province, China. A total of 770 HIV-infected patients between May 2015 and February 2016 were enrolled in Yunnan, China. All patients received ART. All plasma samples were tested for anti-HEV IgG, anti-HEV IgM antibodies using ELISA kits, and HEV RNA by real-time qRT-PCR. Association between anti-HEV antibody positivity and demographic, clinical and laboratory measures was assessed in univariate and multivariate logistic regression models. Of the 770 HIV-infected patients, 342 patients (44.42%) were anti-HEV IgG antibody positive, and six patients (0.78%) were anti-HEV IgM antibody positive. None of the patients was HEV RNA positive, as tested in our assays. We found that age, gender, CD4 cell count, WHO stage, marital status, and total cholesterol levels were associated with HEV infection. We report a high seroprevalence rate and several potential risk factors of HEV infection in a large HIV cohort from Yunnan province in China. Further research on identification of the circulating HEV strains and the clinical outcome of this patient population is required.

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Section: Discussionmentioning

confidence: 59%

Hepatitis E virus infection in HIV‐infected patients: A large cohort study in Yunnan province, China

Zhou

Ren

Xia

et al. 2018

Journal of Medical Virology

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“…A 10‐year gap in knowledge followed, until 2011, when studies from Argentina, Bolivia, Brazil and Colombia, reported respective HEV prevalences . This wave of studies followed the global reports of chronic hepatitis E virus infection by HEV‐3 in immunosuppressed individuals, especially those with solid organ transplantation as well as the reports of extra‐hepatic manifestations of HEV.…”

Section: Detection Of Hev In Humans In South Americamentioning

confidence: 99%

“…Brazil and Argentina are the only countries in South America which have reported studies about HEV circulation in immunocompromised populations (Table ) . In Argentina higher circulation of HEV was registered in HIV+ individuals, compared to blood donors (6.6% vs 1.8%), volunteers (35.7% vs 14.3% or 9.5%, depending on the kit used) and general population (7.3% vs 4.4%) .…”

Section: Detection Of Hev In Humans In South Americamentioning

confidence: 99%

Hepatitis E virus in South America: The current scenario

Pisano

Martinez‐Wassaf²,

Mirazo

et al. 2018

Liver International

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Hepatitis E virus (HEV) is one of the most frequent causes of acute viral hepatitis of enteric transmission worldwide. In South America the overall epidemiology has been little studied, and the burden of the disease remains largely unknown. A research of all scientific articles about HEV circulation in South America until November 2017 was carried out. Human seroprevalences of HEV varied according to the studied population: blood donors presented prevalence rates ranging from 1.8% to 9.8%, while reports from HIV‐infected individuals, transplant recipients and patients on hemodialysis showed higher prevalence rates. Only 2 cases of chronic hepatitis in solid‐organ transplant patients from Argentina and Brazil have been described. Detection of HEV in the swine population is widely prevalent in the region. Anti‐HEV antibodies have also been recently documented in wild boars from Uruguay. Although scarce, studies focused on environmental and food HEV detection have shown viral presence in these kind of samples, highlighting possible transmission sources of HEV in the continent. HEV genotype 3 was the most frequently detected in the region, with HEV genotype 1 detected only in Venezuela and Uruguay. HEV is widely distributed throughout South America, producing sporadic cases of acute hepatitis, but as a possible agent of chronic hepatitis. Finding the virus in humans, animals, environmental samples and food, show that it can be transmitted through many sources, alerting local governments and health systems to improve diagnosis and for the implementation of preventive measures.

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“…In immunocompromised individuals, infection with human immunodeficiency virus (HIV) correlation with long‐term complications by HEV infection is less well established . Most studies have found a higher seroprevalence of HEV in HIV‐infected patients, but there is less convincing evidence of chronicity . Interestingly nonetheless, several studies found an increased seroprevalence of HEV in cirrhotics with HIV, compared to HIV‐infected non‐cirrhotic patients, implicating the virus as a potential risk factor for progression of liver disease to advanced fibrosis stages in this setting .…”

Section: Introductionmentioning

confidence: 99%

“…9,10 Most studies have found a higher seroprevalence of HEV in HIV-infected patients, but there is less convincing evidence of chronicity. 9,11,12 Interestingly nonetheless, several studies found an increased seroprevalence of HEV in cirrhotics with HIV, compared to HIV-infected non-cirrhotic patients, implicating the virus as a potential risk factor for progression of liver disease to advanced fibrosis stages in this setting. 13,14 Overall, there is a paucity of knowledge in regard to risk factors that affect prevalence or predispose to HEV infection in individuals with HIV.…”

Section: Introductionmentioning

confidence: 99%

A mutation in the progesterone receptor predisposes to HEV infection in HIV‐positive patients

Debes

Pas

Groothuismink

et al. 2018

Liver International

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Background and AimsInfection with Hepatitis E virus (HEV) can cause chronic liver disease in immunocompromised hosts. In transplant recipients, the use of certain immunosuppressants and food habits has been proposed as risk factors for HEV. In individuals infected with the human immunodeficiency virus (HIV), risk factors for HEV infection are less clear. We aimed to study the association between a mutation in the progesterone receptor (PR) named PROGINS and HEV‐infected in HIV‐positive individuals.MethodsWe evaluated the presence of the SNP PROGINS via KASP in serum samples of 64 HIV‐positive individuals and 187 healthy controls. We performed ELISA tests to address the serum levels of IL‐10 and IL‐12, as well as T‐cell stimulation assays in peripheral blood to address immune response in individuals with PROGINS.ResultsWe found a significant association between the presence of PROGINS mutation and HEV seroprevalence in individuals infected with HIV (30% in HIV+/HEV+ versus 2% in HIV+/HEV, respectively, P = .009). Moreover, we found that HIV+/HEV+ individuals expressing the PROGINS mutation had lower serum levels of IL‐10 and higher levels of IL‐12. The presence of the mutation led to a reduced response upon stimulation of CD4+ and CD8+ T cells compared to those without the mutation, suggesting an immune modulation associated with PROGINS.ConclusionsOur study identified a mutation in the PR that provides significant insights into mechanisms of HEV infection in immunosuppressed individuals.

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Increased Hepatitis E Virus Seroprevalence Correlates with Lower CD4+ Cell Counts in HIV-Infected Persons in Argentina

Cited by 22 publications

References 15 publications

Hepatitis E virus infection in HIV‐infected patients: A large cohort study in Yunnan province, China

Hepatitis E virus infection in HIV‐infected patients: A large cohort study in Yunnan province, China

Hepatitis E virus in South America: The current scenario

A mutation in the progesterone receptor predisposes to HEV infection in HIV‐positive patients

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