Hepatitis E in a Portuguese cohort of human immunodeficiency virus positive patients: High seroprevalence but no chronic infections

Filipe, Rita; Prista‐Leão, Beatriz; Silva‐Pinto, André; Abreu, Ilda; Serrão, Rosário; Costa, Raquel; Guedes, Edite; Sobrinho‐Simões, Joana; Sarmento, António; Koch, Carmen M.; Santos, L

doi:10.1002/hsr2.624

Cited by 4 publications

(3 citation statements)

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“…Additionally, ribavirin has been evaluated for its effectiveness in treating this patient population (Carmo et al, 2016 ). The persistence of HEV infection was also reported in a patient with myelofibrosis (Filipe et al, 2022 ; Ribeiro da Cunha & Marques, 2021 ) but no chronic infections was observed in a Portuguese cohort of HIV (Filipe et al, 2022 ; Ribeiro da Cunha & Marques, 2021 ).…”

Section: Resultsmentioning

confidence: 71%

“…Knowing that HEV-3 infection may progress into a chronic hepatitis in immunosuppressed patients (Wang & Meng, 2021 ), HEV diagnosis in these type of patients should be carried out since they can benefit from ribavirin treatment (Correia et al, 2022 ). HEV-3 has also been reported in HIV patients (Rivero-Juarez et al, 2017b ), with some studies showing low or no detection rates of HEV RNA in these patients, (Jardi et al, 2012 ; Madejón et al, 2009 ; A. Rivero-Juarez et al, 2017b ; Rodríguez-Tajes et al, 2020 ), in spite of the high anti-HEV seroprevalences detected in these patients (Filipe et al, 2022 ; López-López et al, 2019 , 2022 ; Mateos-Lindemann et al, 2014 ; Merchante et al, 2015 ; Pineda et al, 2014 ; Riveiro-Barciela et al, 2014 ; Antonio Rivero-Juarez et al, 2015a , 2015b ; Vázquez-Morón et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

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Hepatitis E Virus in the Iberian Peninsula: A Systematic Review

et al. 2023

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One of the most frequent causes of acute viral hepatitis is hepatitis E virus (HEV) causing 20 million infections worldwide each year and 44,000 deaths. Studies on HEV in the Iberian Peninsula have been increasing through time with HEV infection being identified in humans and animals. The aim of the present systematic review was to compile and evaluate all the published data on HEV from studies performed in humans, animals and environmental samples in the Iberian Peninsula. The electronic databases Mendeley, PubMed, Scopus, and Web of Science were thoroughly searched, and research published up until February 01, 2023 were included. Resulting in a total of 151 eligible papers by full reading and application of PRISMA exclusion/inclusion criteria. Overall, the present review shows that several HEV genotypes, namely HEV-1, 3, 4, and 6 as well as Rocahepevirus, are circulating in humans, animals, and in the environment in the Iberian Peninsula. HEV-3 was the most common genotype circulating in humans in Portugal and Spain, as expected for developed countries, with HEV-1 only being detected in travelers and emigrants from HEV endemic regions. Spain is the biggest pork producer in Europe and given the high circulation of HEV in pigs, with HEV-3 being primarily associated to zoonotic transmission through consumption of swine meat and meat products, in our opinion, the introduction of an HEV surveillance system in swine and inclusion of HEV in diagnostic routines for acute and chronic human hepatitis would be important. Additionally, we propose that establishing a monitoring mechanism for HEV is crucial in order to gain a comprehensive understanding of the prevalence of this illness and the various strains present in the Iberian Peninsula, as well as their potential impact on public health.

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Section: Resultsmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Hepatitis E Virus in the Iberian Peninsula: A Systematic Review

et al. 2023

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“…Both acute and chronic hepatitis E have both been described in PLWH, especially among MSM [71][72][73] and in the subset of patients with low CD4 counts, respectively 72 . However, to date, there is no evidence in favor of sexual HEV transmission 74,75 .…”

Section: Hepatitis Ementioning

confidence: 99%

Viral hepatitis in persons living with HIV in the post-COVID era

Soriano¹,

Moreno-Torres²,

Mendoza³

et al. 2023

AIDSRev

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Coinfection with hepatitis viruses A to E is frequent in persons living with HIV (PLWH) and causes significant morbidity and mortality. Oro-fecal transmissible hepatitis A and E mostly produce acute self-limited episodes in poor income regions and in non-vaccinated travelers. In high-income countries, outbreaks of hepatitis A occur in men having sex with men (MSM) and chronic hepatitis E is occasionally reported among PLWH with severe immunodeficiency. Chronic hepatitis B, C, and D are frequent in PLWH in highly endemic regions and globally in persons who inject drugs (PWID) and MSM. Progression to liver cirrhosis and development of hepatocellular carcinoma (HCC) is major clinical complications in coinfected patients. Current estimates for PLWH are of 38 million worldwide. Roughly 12% have chronic viral hepatitis (5 million). Coinfection figures are of 5-10% for HBV (2-4 million), 4% for HCV (1.5 million), and 15% of HBsAg+ for HDV (0.5 million). Oral direct-acting antivirals (DAA) cure almost all treated patients with hepatitis C. However, given that there is no protective HCV immunity, PLWH with high-risk behaviors may experience HCV reinfection episodes. Tenofovir is the drug of choice in PLWH with chronic hepatitis B, given its dual effect on HIV and HBV. Lifelong oral tenofovir suppresses HBV replication and ameliorate liver damage. However, the risk of HCC persists even in the absence of cirrhosis. Finally, HDV causes the worst of viral hepatitis with faster progression to cirrhosis and HCC. An entry inhibitor, bulevirtide, has recently been approved and another drug, lonafarnib, is completing Phase 3 trials. Combination antiviral therapy for hepatitis D could improve dramatically the poor prognosis of HIV-HDV coinfected patients. The resumption of good medical practices in PLWH after the big disruption caused by COVID-19 will reduce the burden of viral hepatitis coinfections. Renewed efforts on HAV and HBV vaccination of susceptible individuals and earlier and wider prescription of antiviral therapy for HBV, HCV, and/or HDV coinfection should be prioritized in PLWH. The benefits of innovative strategies for viral hepatitis, including pre-exposure prophylaxis or use of long-acting antivirals, warrant further consideration in PLWH.

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Hepatitis E in a Portuguese cohort of human immunodeficiency virus positive patients: High seroprevalence but no chronic infections

Filipe

Prista‐Leão

Silva‐Pinto

et al. 2022

Health Science Reports

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Introduction: Hepatitis E virus (HEV) infection causes zoonotic hepatitis in Europe, with a higher risk of complications in immunocompromised hosts. HEV natural history in human immunodeficiency virus (HIV) positive patients is not fully understood, and its prevalence is unknown.Objectives: To study the seroprevalence of HEV and prevalence of chronic HEV in HIV-positive patients from Porto, Portugal.Methods: We randomly selected patients from the cohort of HIV-positive patients followed in our hospital. We performed an enzyme-linked immunosorbent assay to search for immunoglobulin G for HEV. When the absorbance/cut-off was inferior to 3.5, the test was repeated, and a confirmatory test executed in that sample. For reactive tests and for immunosuppressed patients (CD4 count < 200/mm 3 ) with nonreactive test, a polymerase chain reaction (PCR) test was also performed. Results:We included 299 patients. The mean age was 48 and 75.3% were men.Regarding HIV infection, the median follow-up time was 10 years, the acquisition was mainly heterosexual contact, and 94% were on antiretroviral therapy. Seventysix patients (25.4%) had reactive immunoglobulin G (IgG) hepatitis E serology.Patients with a reactive test were older (statistically significant difference).Otherwise, there was no difference between groups concerning birthplace, rural residence, chronic viral hepatitis coinfection, or cirrhosis. Nadir and actual T CD4+ lymphocyte counts did not differ significantly from patients with HEV reactive and nonreactive serology. Gamma-glutamyl-transferase (GGT) was higher in patients with reactive IgG HEV. All serum HEV PCR tests were negative.

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Hepatitis E in a Portuguese cohort of human immunodeficiency virus positive patients: High seroprevalence but no chronic infections

Cited by 4 publications

References 29 publications

Hepatitis E Virus in the Iberian Peninsula: A Systematic Review

Hepatitis E Virus in the Iberian Peninsula: A Systematic Review

Viral hepatitis in persons living with HIV in the post-COVID era

Hepatitis E in a Portuguese cohort of human immunodeficiency virus positive patients: High seroprevalence but no chronic infections

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