Lack of hepatitis E virus infection in HIV patients with advanced immunodeficiency or idiopathic liver enzyme elevations

Madejón, Antonio; Vispo, Eugenia; Bottecchia, Marcelle; Sánchez-Carrillo, Marta; García-Samaniego, Javier; Soriano, Vincent

doi:10.1111/j.1365-2893.2009.01138.x

Cited by 52 publications

(46 citation statements)

References 9 publications

(9 reference statements)

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“…The current study shows that, in southwest England, in an unselected group of HIV-infected patients, none of the patients tested showed evidence of HEV viraemia, thus excluding the possibility of chronic HEV coinfection. These data concur with those of a similar study from Spain [22] that found no evidence of HEV viraemia in 93 HIV-infected patients. A study from Germany also found no evidence of chronic HEV coinfection in 123 HIV-infected patients, but this study was somewhat limited, as only six patients (those who were IgG positive) were tested for HEV using molecular techniques [23].…”

Section: Discussionsupporting

confidence: 92%

Hepatitis E virus coinfection in patients with HIV infection

et al. 2011

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Hepatitis E virus (HEV) infection is an emerging infection in developed countries and is thought to be a porcine zoonosis. HEV can cause chronic infection and cirrhosis in the immunosuppressed, including patients with HIV infection. Little is known about HEV and HIV coinfection. The aim of the study was to document the incidence of chronic HEV coinfection in patients with HIV infection and to determine the anti-HEV seroprevalence and compare it with that of a control population. MethodsA cohort/case-control study was carried out in two teaching hospitals in southwest England. A total of 138 patients with HIV infection were tested for HEV using an immunoassay for anti-HEV immunoglobulin M (IgM) and IgG and reverse transcriptase-polymerase chain reaction (RT-PCR), and 464 control subjects were tested for anti-HEV IgG. Demographic, lifestyle and laboratory data were prospectively collected on each patient with HIV infection. The anti-HEV IgG seroprevalence in patients with HIV infection was compared with that in controls and demographic risk factors for HEV exposure were explored using logistic regression models. ResultsThere was no difference in anti-HEV IgG seroprevalence between the HIV-infected patients and controls. The only risk factor predictive of anti-HEV seropositivity was the consumption of raw/ undercooked pork; sexual risk factors were unrelated. No patient with HIV infection had evidence of chronic coinfection with HEV Conclusions Anti-HEV seroprevalence is similar in controls and patients with HIV infection. Risk factor analysis suggests that HEV is unlikely to be transmitted sexually. Chronic coinfection with HEV was absent, indicating that chronic HEV/HIV coinfection is not a common problem in this cohort.

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Section: Discussionsupporting

confidence: 92%

Hepatitis E virus coinfection in patients with HIV infection

et al. 2011

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“…More recent studies focusing on detection of anti-HEV IgM, IgG, or RNA have identified both acute (266,(303)(304)(305)(306)(307)(308)(309)(310)(311)(312)(313) and chronic (266,(268)(269)(270)(271)(272)(273)(274) HEV infections in HIV-positive patients, though it remains unclear whether or not seroprevalence is any greater in people with HIV (272,273,300,309,310,(314)(315)(316)(317)(318). Chronic HEV infections in HIV-positive individuals have been associated with quick progression to cirrhosis (269)(270)(271), though it is not clear whether HEV-linked cryptogenic cirrhosis is more common in HIV-infected individuals than in the general population (310,311,315,319).…”

Section: Immunosuppression and Impaired Viral Clearancementioning

confidence: 99%

“…Chronic HEV infections in HIV-positive individuals have been associated with quick progression to cirrhosis (269)(270)(271), though it is not clear whether HEV-linked cryptogenic cirrhosis is more common in HIV-infected individuals than in the general population (310,311,315,319).…”

Section: Immunosuppression and Impaired Viral Clearancementioning

confidence: 99%

Host Immune Status and Response to Hepatitis E Virus Infection

2014

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SUMMARY Hepatitis E virus (HEV), identified over 30 years ago, remains a serious threat to life, health, and productivity in developing countries where access to clean water is limited. Recognition that HEV also circulates as a zoonotic and food-borne pathogen in developed countries is more recent. Even without treatment, most cases of HEV-related acute viral hepatitis (with or without jaundice) resolve within 1 to 2 months. However, HEV sometimes leads to acute liver failure, chronic infection, or extrahepatic symptoms. The mechanisms of pathogenesis appear to be substantially immune mediated. This review covers the epidemiology of HEV infection worldwide, the humoral and cellular immune responses to HEV, and the persistence and protection of antibodies produced in response to both natural infection and vaccines. We focus on the contributions of altered immune states (associated with pregnancy, human immunodeficiency virus [HIV], and immunosuppressive agents used in cancer and transplant medicine) to the elevated risks of chronic infection (in immunosuppressed/immunocompromised patients) and acute liver failure and mortality (among pregnant women). We conclude by discussing outstanding questions about the immune response to HEV and interactions with hormones and comorbid conditions. These questions take on heightened importance now that a vaccine is available.

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“…All cases of chronic hepatitis E in patients with HIV had CD4 count less than 200. Prevalence of chronic HEV in HIV patients is low and has been reported from 0% to 0.5% in different studies [49][50][51][52] . Recently, few cases of chronic hepatitis E have also been reported in immunocompetent patients [53][54][55] .…”

Section: Extra Hepatic Manifestations Of Chronic Hepatitis Ementioning

confidence: 97%

Chronic hepatitis E: A brief review

Murali

Kotwal

Chawla

2015

WJH

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Hepatitis E viral infection has traditionally been considered an acute, self-limited, water borne disease similar to hepatitis A, endemic to developing countries. However, over the past decade, zoonotic transmission and progression to chronicity in human patients has been identified, resulting in persistently elevated transaminase levels, progressive liver injury and cirrhosis. In addition to liver injury, neurological, renal and rheumatological manifestations have also been reported. Chronic hepatitis E occurs mainly in immunosuppressed individuals such as transplant recipients, human immunodeficiency virus patients with low CD4 counts and in patients with hematological malignancies receiving chemotherapy. Diagnosis is established by persistent elevation of hepatitis E virus RNA in the stool or serum. This population often requires treatment with antiviral agents, particularly ribavirin, as spontaneous clearance with reduction in immunosuppression occurs only in about a third of the patients. The purpose of this review, is to further discuss the clinical presentation, and recent advances in diagnosis, treatment and prophylaxis of chronic hepatitis E.

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Lack of hepatitis E virus infection in HIV patients with advanced immunodeficiency or idiopathic liver enzyme elevations

Cited by 52 publications

References 9 publications

Hepatitis E virus coinfection in patients with HIV infection

Hepatitis E virus coinfection in patients with HIV infection

Host Immune Status and Response to Hepatitis E Virus Infection

Chronic hepatitis E: A brief review

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