Detection and characterization of hepatitis E virus genotype 3 in HIV-infected patients and blood donors from southern Brazil

Abstract

Background: Hepatitis E virus genotype 3 (HEV-3) infection usually causes self-limited acute hepatitis. In immunosuppressed patients, HEV-3 infection can rapidly progress to chronic hepatitis and cirrhosis. In southern Brazil, data on HEV seroprevalence are scarce. Methods: Testing for HEV RNA and antibodies (anti-HEV) was performed for 320 HIV-infected patients followed at the HIV/AIDS Service of the Federal University of Rio Grande between 2012 and 2013, as well as 281 blood donor samples obtained in 2015. Variables associated with anti-HEV positivity were assessed by multivariable logistic regression analysis. Results: HIV and blood donor groups showed similar HEV seroprevalence (6.7% and 7.1%, respectively). Risk factors associated with anti-HEV detection were older age, marital status, a higher number of sexual partners, poor sanitation, and alcohol use (HIV group), and living in a rural area (blood donors). HEV RNA was detected in eight serum samples from HIV-infected patients and in one blood donor, who was also positive for anti-HEV IgM and IgG. Conclusions: The prevalence rates of HEV infection were comparable between HIV-seropositive patients who were not severely immunocompromised and blood donors. The blood donor's HEV isolate showed high similarity with swine HEV strains from Brazilian herds in the same region, thus indicating a potential risk of foodborne and parenteral transmission via blood transfusion.

Serological and molecular prevalence of hepatitis E virus among blood donors from Uruguay

“…16,17 In addition, anti-HEV Ig prevalence in blood donors from this study was found to increase with age, a finding that is in concordance with previous data published elsewhere. 16,18 On the other hand, it may be noted that severe discrepancies and the existence of wide variability in terms of sensitivity and specificity have been reported for commercially available serologic tests. 3 The enzyme-linked immunosorbent assay used in this study is the same of that employed in the two reports from Argentina.…”

“…All these three positive samples had both anti‐IgG‐ and anti‐IgM‐specific Abs. Unfortunately, in South America, only the study from Southern Brazil 16 had performed both Abs and RNA detection in blood donors, thus limiting the robustness of any comparative analysis in the region concerning HEV epidemiology in this group. Though higher than most of the European countries, the overall RNA detection rate in blood donors from Brazil is still quite lower than the one reported in this study (0.3% vs a minimum of 0.75%).…”

“…HEV-RNA was not detected in the seronegative samples analyzed, which is in agreement with a previous study from Brazil. 16 In fact, the HEV-RNA prevalence rate even among seropositive individuals can be relatively low. 21 Nevertheless, some studies from European countries have reported the presence of HEV-RNA in seronegative samples from blood donors, 22 supporting the notion that molecular tests might be a more reliable approach to screen HEV in blood banks.…”

Cross-sectional Assessment of HIV and Hepatitis A, B, C, D, and E among Individuals Surveyed in National Health and Nutrition Evaluation Survey, 1999–2018

“…11 Though Hepatitis D is rarer than other strains at a prevalence of 0.80% and 13.02% among Hepatitis B carriers, there is estimated to be 48-60 million infections globally, with a progression to cirrhosis within 5 year and hepatocellular carcinoma within 10 years. 12 Out of all the strains Hepatitis E remains the least understood especially in third world counties, such as Brazil 13 , Central African Republic 14 , Nigeria 15 , Nepal 16 , and India. 17 There is limited treatment for acute hepatitis E, but chronic in the immunosuppressed can be treated with ribavirin, and people living in China can be vaccinated against hepatitis E, but the vaccine is not widespread.…”

Hepatitis E Virus in People Who Use Crack-Cocaine: A Cross-Sectional Study in a Remote Region of Northern Brazil

“…The prevalence of anti-HEV immunoglobulin G (IgG) antibodies is variable, with the highest rates recorded in renal transplant patients (15.0%), women at risk of human immunodeficiency virus (HIV) infection (17.7%), cleaning service workers (13.2%), and individuals from rural areas (12.9%) [ 12 , 13 , 14 , 15 ]. The intake of contaminated water, consumption of raw or undercooked meat and pork products, and occupational risk from contact with farm animals (e.g., pigs) have been suggested as factors associated with HEV transmission and infection [ 4 , 16 , 17 , 18 , 19 ]. Increasing age has also been recorded as an important factor correlated with viral exposure [ 20 ].…”