Hepatitis E Virus Does Not Contribute to Hepatic Decompensation Among Patients With Advanced Chronic Hepatitis C

The highest recorded hepatitis C virus (HCV) prevalence worldwide is in Egypt. A high prevalence of hepatitis E virus (HEV) in chronic liver disease has been reported. The aim of this study was to study prevalence, incidence, and outcome of HCV infection in an Egyptian Nile Delta village and the relation between HEV infection and HCV-related chronic hepatic affection. This prospective cohort study included 2085 Nagreej village residents. Mass HCV screening was conducted and testing for HEV antibodies among HCV-infected patients performed. The annual incidence of HCV was recorded. Five hundred five (24.22%) of the tested villagers were positive for HCV RNA. Prevalence escalated with age and male sex. The main recorded risk factors were a history of surgery, dental procedures, hospitalization, blood transfusion, and antischistosomal treatment. HEV IgG antibody was positive in 71.4% of individuals with chronic HCV and 96.1% with advanced liver disease (cirrhosis ± hepatocellular carcinoma (HCC)). After 1 year, 29 of the 1390 HCV Ab negative villagers had a positive HCV PCR, placing an annual incidence of new HCV infections at 2.09%. The Egyptian HCV prevalence remains high with infection particularly among the elderly. The annual incidence in a small Nile Delta village is 2.086%. HCV-HEV co-infection may lead to a worse prognosis among Egyptians with chronic liver disease.

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“…On the other hand, Samala et al (2016) in the USA did not recognize the same effect of hepatitis E on patients with HCVrelated CLD.…”

Section: Discussionmentioning

confidence: 83%

HCV and HEV: two players in an Egyptian village, a study of prevalence, incidence, and co-infection

Elhendawy

Abo-Ali

Hagras

et al. 2020

Environ Sci Pollut Res

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“…How commonly HEV causes decompensation in such patients in developed countries has not been systematically studied. Hepatitis E appears to be a rare cause of acute liver failure in the United States and does not appear to be a significant cause of hepatic decompensation among persons with advanced chronic hepatitis C in the United States . However, in a recent retrospective study from Germany approximately 10% of patients with acute liver failure had evidence for acute HEV infection .…”

Section: Discussionmentioning

confidence: 99%

Hepatitis E virus infection in the Irish blood donor population

et al. 2016

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“…Similarly, studies carried out in cirrhotic patients in France or the United Kingdom found low liver decompensation due to HEV infection, 3.5% and 3.2%, respectively (Blasco‐Perrin et al., 2015 ; Haim‐Boukobza et al., 2015 ). In addition, a study conducted in the United States found an incidence of 4.5% anti‐HEV IgG antibodies in decompensated patients (Samala et al., 2016 ). These differences observed between Asia and America and Europe are not related to the prevalence and incidence of HEV infection in this population, because studies carried out in patients with chronic hepatitis C in the United States or with chronic liver diseases in Spain showed prevalences comparable to our study (Samala et al., 2016 ; Vázquez‐Morón et al., 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Seroreversion of IgG anti‐HEV in HIV cirrhotic patients: A long‐term multi‐sampling longitudinal study

López‐López

Frías

Camacho

et al. 2022

Transbounding Emerging Dis

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The aim of our study was to evaluate HEV antibody kinetics in HIV/HCV‐coinfected patients with cirrhosis. A longitudinal retrospective study was designed. Patients were followed up every 6 months; anti‐HEV IgG and IgM antibodies levels and HEV‐RNA by qPCR were analysed. The prevalence and incidence of every HEV infection marker were calculated. The kinetics of anti‐HEV IgG and IgM during the follow‐up were evaluated. Seventy‐five patients comprised the study population. The seroprevalence observed was 17.3%. None showed IgM antibodies or HEV‐RNA at baseline. None showed detectable HEV viral load during the study period. After a median follow‐up of 5.1 years, two of 62 seronegative patients (3.2%) seroconverted to IgG antibody. The incidence for IgM was 2.7%. Of the 13 patients with IgG seropositivity at baseline, five (38.5%) seroreverted. Meanwhile, of the two patients who exhibited IgM positivity during the study, one (50%) showed intermittent positivity. We found that HEV seropositivity is common in HIV/HCV‐coinfected cirrhotic patients. A remarkable rate of IgG seroreversions and IgM intermittence was found, limiting the use of antibodies for the diagnosis of HEV infection in this population.

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Hepatitis E Virus Does Not Contribute to Hepatic Decompensation Among Patients With Advanced Chronic Hepatitis C

Cited by 8 publications

References 22 publications

HCV and HEV: two players in an Egyptian village, a study of prevalence, incidence, and co-infection

HCV and HEV: two players in an Egyptian village, a study of prevalence, incidence, and co-infection

Hepatitis E virus infection in the Irish blood donor population

Seroreversion of IgG anti‐HEV in HIV cirrhotic patients: A long‐term multi‐sampling longitudinal study

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