Hepatitis E virus infection among patients with altered levels of alanine aminotransferase

Conte, D.; Luna, Luciano Kleber Souza; Passarni, Amanda; Alves, Vitória Rodrigues Guimarães; Caldeira, Débora Bellini; Cruz, Jéssica Santiago; Gouveia, Viviane Almeida; Bellei, Nancy; Granato, Celso

doi:10.1016/j.bjid.2021.101655

Cited by 6 publications

(6 citation statements)

References 17 publications

(24 reference statements)

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“…In a study of 354 HIV-infected patients, among whom the prevalence of anti-HEV IgG positivity was 10.7%, no HEV RNA was detected. In another, more recent study, which included 400 patients with elevated transaminases, an HEV RNA detection rate of 4% was reported [18,46]. According to the manufacturer, the kit employed for qRT-PCR in the present study has an analytical sensitivity of 0.20 IU/µL (95% CI: 0.12-0.45).…”

Section: Discussionmentioning

confidence: 67%

The Risk of Acute or Reactivated Hepatitis E Virus Infection at a Liver Transplant Center in Brazil: Observational Cohort Study

Zicker,

Pinho,

Welter

et al. 2023

Preprint

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Hepatitis E virus is a major etiological agent of chronic hepatitis in immunosuppressed individuals. Studies on HEV in the context of liver transplantation have produced mixed results, most of the data coming from studies conducted in high-income countries. This was a prospective cohort study of liver transplant recipients in southeastern Brazil. Recipients were systematically followed for one year, with the objective of determining the prevalence, incidence, genotype, and natural history of HEV infection in this population. We included 107 liver transplant recipients and 83 deceased donors. Positivity for anti-HEV IgG was detected in 11 (10.2%) of the recipients and in eight (9.7%) of the donors. None of the patients tested positive for HEV RNA at baseline or during follow-up. There were no episodes of reactivation or seroconversion, even in cases of serological donor-recipient mismatch or in recipients with acute hepatitis. Acute and chronic HEV infections seem to be rare events in the region studied. That could be attributable to social, economic, and environmental factors. Our data indicate that, among liver transplant recipients, hepatitis E should be investigated only when there are elevated levels of transaminases with no defined cause, as part of the differential diagnosis of seronegative hepatitis after transplantation.

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Section: Discussionmentioning

confidence: 67%

The Risk of Acute or Reactivated Hepatitis E Virus Infection at a Liver Transplant Center in Brazil: Observational Cohort Study

Zicker,

Pinho,

Welter

et al. 2023

Preprint

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“…Transaminase levels were two to ve times higher than normal in HEV-infected individuals, con rming the presence of hepatic cytolysis that usually accompanies HEV infection [29].…”

Section: Discussionmentioning

confidence: 85%

Hepatitis E outbreak in the health district of Bocaranga-Koui, Central African Republic, 2018-2019

Nombot-Yazenguet,

Doté,

Koyaweda

et al. 2023

Preprint

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Background: Hepatitis E virus (HEV) is one of major public health diseases causing large outbreaks and sporadic cases of acute hepatitis. We investigated an outbreak of HEV infection that occured in september 2018 in the health district (HD) of Bocaranga-Koui in the northwestern part of Central African Republic (CAR). Methods: Blood samples were collected from 352 patients aged 0-85 years suspected for yellow fever (YF) according to the World Health Organization YF case definition. The notification forms from cases recorded were used. Water sources consumed in the areas were also collected. Human samples found negative for anti-YF IgM were then ELISA-tested for anti-HEV IgM and IgG antibodies. Positive anti-HEV (IgM and/or IgG) samples and collected water were subjected to molecular biology tests. Results: Of the 352 icterus patients included, anti-HEV IgM was found in 142 people (40.3%) and anti-HEV IgG in 175 (49.7%). Although HEV infection was detected in all age groups, there was significant difference between age groups (P = 0.001). Elevated levels of serum aminotransferase were observed in anti-HEV IgM-positive persons. Phylogenetic analysis showed HEV genotype 1e in infected patients and also in the contaminated water. Conclusion: This epidemic showed that CAR remains an HEV-endemic area. The genotype 1e strain is responsible for the HEV outbreak in Bocaranga-Koui health district. It is necessary to implement basic conditions of hygiene and sanitation to prevent the outbreak of an hepatitis E epidemic, by facilitating access to clean drinking water for the population, by launching intensive work to raise awareness for basic hygiene measures, by setting up targeted hygiene promotion activities and, finally, by making a care service available.

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Section: Discussionmentioning

confidence: 99%

The Risk of Reinfection or Primary Hepatitis E Virus Infection at a Liver Transplant Center in Brazil: An Observational Cohort Study

Zicker,

Pinho,

Welter

et al. 2024

Viruses

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The hepatitis E virus is a major etiological agent of chronic hepatitis in immunosuppressed individuals. Seroprevalence in the liver transplantation setting varies according to the seroprevalence of the general population in different countries. This was a prospective cohort study of liver transplant recipients in southeastern Brazil. Recipients were systematically followed for one year, with the objective of determining the prevalence, incidence, and natural history of HEV infection in this population. We included 107 liver transplant recipients and 83 deceased donors. Positivity for anti-HEV IgG was detected in 10.2% of the recipients and in 9.7% of the donors. None of the patients tested positive for HEV RNA at baseline or during follow-up. There were no episodes of reactivation or seroconversion, even in cases of serological donor-recipient mismatch or in recipients with acute hepatitis. Acute and chronic HEV infections seem to be rare events in the region studied. That could be attributable to social, economic, and environmental factors. Our data indicate that, among liver transplant recipients, hepatitis E should be investigated only when there are elevated levels of transaminases with no defined cause, as part of the differential diagnosis of seronegative hepatitis after transplantation.

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Hepatitis E virus infection among patients with altered levels of alanine aminotransferase

Cited by 6 publications

References 17 publications

The Risk of Acute or Reactivated Hepatitis E Virus Infection at a Liver Transplant Center in Brazil: Observational Cohort Study

The Risk of Acute or Reactivated Hepatitis E Virus Infection at a Liver Transplant Center in Brazil: Observational Cohort Study

Hepatitis E outbreak in the health district of Bocaranga-Koui, Central African Republic, 2018-2019

The Risk of Reinfection or Primary Hepatitis E Virus Infection at a Liver Transplant Center in Brazil: An Observational Cohort Study

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