Positive hepatitis E and Epstein Barr virus serology in a patient with jaundice after travel

Tappe, Dennis; Müller, Antje; Ziegler, Uwe; Weißbrich, Benedikt; Schubert, Jörg; Günther, Stephan; Schmidt‐Chanasit, Jonas; Stich, August

doi:10.1016/j.jcv.2010.02.005

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…6), whereas they have been previously described as becoming negative 2–3 months following hepatitis onset in most cases [Takahashi et al, 2005; Bendall et al, 2008]. The low (≤5.5) ODR observed may also argue for false positive results, which have been described previously in association with primary Epstein–Barr Virus infection [Tappe et al, 2010]. Nevertheless, the specificity of the anti‐HEV IgM assay used in the present study was reported to be 100% when tested on 406 samples in France [Legrand‐Abravanel et al, 2009b].…”

Section: Discussionmentioning

confidence: 78%

Hepatitis E virus infection in patients infected with the human immunodeficiency virus

Kaba

Richet

Ravaux

et al. 2011

Journal of Medical Virology

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Hepatitis E virus (HEV) is a newly-identified causative agent of acute and chronic hepatitis in severely immunocompromized patients. The present study sought to assess the prevalences of past, recent, on-going, and chronic HEV infections in patients infected with human immunodeficiency virus (HIV) in Marseille, South-eastern France, and to determine if they were correlated with the patients' immunological status or with cirrhosis. Anti-HEV IgG and IgM and HEV RNA testing were concurrently performed on the plasma from 184 patients infected with HIV, including 81 with a CD4+ T-lymphocyte count (CD4 count) <50 cells/mm(3) and 32 with a cirrhosis. Prevalence of anti-HEV IgG and IgM was 4.4% (8/184) and 1.6% (3/184), respectively. Past, recent, and on-going infections were observed in 3.3% (6/184), 1.6% (3/184), and 0.5% (1/184) of the patients, respectively. Anti-HEV antibodies prevalence did not differ significantly according to CD4 count, cirrhosis, sex, age, mode of HIV transmission, and infection with hepatitis B or C virus. Anti-HEV IgG seroreversion was observed in two patients. The patient whose plasma tested positive for HEV RNA had a CD4 count <50 cells/mm(3) ; HEV genotype was 3f. In this patient, longitudinal testing showed HEV RNA positivity during a 10-month period, indicating chronic HEV infection; in contrast, anti-HEV IgG never tested positive. Further studies are needed to evaluate the performance of commercial HEV serological assays in patients infected with HIV and to assess the actual incidence, prevalence, and outcome of HEV infection in this special group of patients. HEV RNA testing is necessary for such purposes.

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Section: Discussionmentioning

confidence: 78%

Hepatitis E virus infection in patients infected with the human immunodeficiency virus

Kaba

Richet

Ravaux

et al. 2011

Journal of Medical Virology

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“…Third, financial instability and poverty are also associated with increased risks of HEV infection [4]. The clinical symptoms of hepatitis E are typical of selflimiting, acute viral hepatitis in general [16,31]. Severe hepatitis E can occur in the elderly, pregnant women and people with chronic hepatitis B and chronic hepatitis C [11,17,32].…”

Section: Discussionmentioning

confidence: 99%

Increased risk of hepatitis E virus infection in schizophrenia

Xue

Sun

et al. 2012

Arch Virol

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Until now, the risk of HEV infection in schizophrenia was unknown. The present results showed that the seroprevalence of anti-HEV IgG and anti-HEV IgM in schizophrenia were significantly higher than that in healthy controls. Anti-HEV IgG positivity increased with age and with the duration of disease in schizophrenia patients. Moreover, schizophrenia patients with increased CD4(+)/CD8(+) T-cell ratios (>2.03) had higher anti-HEV IgG detection rates than those with normal ratios (1.05-2.03). Compared with the schizophrenia patients who tested anti-HEV IgG negative, the levels of interleukin-4 and interleukin-10 (Th2 cytokines) were significantly higher, while the interleukin-12 (Th1 cytokine) level was significantly lower, in those with anti-HEV IgG positivity. Of five schizophrenia patients who were anti-HEV IgM positive, four had elevated CD4(+)/CD8(+) T-cell ratios. HEV RNA was isolated from one of these four patients and classified as genotype 4. Anti-HEV IgM positivity was not detected among healthy controls. Therefore, schizophrenia patients exhibited a higher risk of HEV infection than controls.

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“…In support of their conclusion, the authors cited literature describing the occurrence of positive values for hepatitis E IgG in hepatitis A, B and C infection and positive values for hepatitis E IgM in acute Epstein–Barr virus and cytomegalovirus infection, in the absence of concomitant hepatitis E infection. Therefore, for definitive diagnosis the authors suggest RT-PCR must be undertaken 16. This can prove difficult in a delayed presentation such as ours because the period of hepatitis E viraemia is brief – by a few days to weeks after the onset of clinical symptoms, hepatitis E viral RNA is cleared from the blood; however, it is shed in the stool for a further 2 weeks 1…”

Section: Discussionmentioning

confidence: 96%