Serological and molecular markers of hepatitis E virus infection in HIV-infected patients in Brazil

Abstract

In Brazil, the circulation of hepatitis E virus (HEV) has been demonstrated in distinct groups of individuals and some animals, but its prevalence among individuals with human immunodeficiency virus (HIV) infection is unknown. This study aimed to assess the frequency of serological and molecular HEV markers in individuals infected with HIV from São Paulo, Brazil. Serum and plasma samples of 354 HIV-infected patients collected between 2007 and 2013 were included. All samples were tested for anti-HEV IgG and IgM antibodies and HEV RNA. Anti-HEV IgG and IgM antibodies were detected in 10.7% (38/354) and 1.4% (5/354) of the samples, respectively. Both antibodies were detected simultaneously in only two samples. HEV RNA was not detected in any sample. There was no significant correlation of anti-HEV serological status (positivity to anti-HEV IgG and/or IgM) with sex, age, CD4 T cell count, HIV viral load, antiretroviral therapy, liver enzyme levels, or coinfection with hepatitis B virus and/or hepatitis C virus. Our study provides serological evidence of past and recent HEV infections in HIV-infected patients from São Paulo, Brazil. However, the occurrence of ongoing HEV infection appears be a rare event in this population.

Detection and quantification of hepatitis E virus in the absence of IgG and IgM anti-HEV in HIV-positive patients

“…The prevalence was considered to be average in comparison to the prevalence of HIV/HEV co-infection described worldwide, which varies from country to country and according to the methodology used. For example, the prevalence ranges from 0% to 4%: 0% in Brazil (Ferreira et al 2018). In our study, a viraemia of 3Á6% was found.…”

“…A recent study conducted in São Paulo, Brazil did not find any HEV RNA‐positive samples in 354 HIV‐positive patients (Ferreira et al . ). In our study, a viraemia of 3·6% was found.…”

“…For example, the prevalence ranges from 0% to 4%: 0% in Brazil (Ferreira et al . ), 0·5% in France (Kaba et al . ), 0·95% in Poland (Bura et al .…”

Hepatitis E virus in South America: The current scenario

“…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.…”

“…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%) .…”