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HIV , HEV and cirrhosis: evidence of a possible link from eastern Spain
Author(s) -
Jardi R,
Crespo M,
Homs M,
Eynde E,
Girones R,
RodriguezManzano J,
Caballero A,
Buti M,
Esteban R,
RodriguezFrias F
Publication year - 2012
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2011.00985.x
Subject(s) - medicine , hepatitis e virus , cirrhosis , interquartile range , serology , immunology , virology , hepatitis c , viral hepatitis , hepatitis c virus , viral load , gastroenterology , antibody , virus , genotype , biology , biochemistry , gene
Objectives The aim of the study was to assess the seroprevalence of hepatitis E virus ( HEV ) infection in an HIV ‐infected population, as determined by HEV immunoglobulin G ( IgG ) antibodies (anti‐ HEV ). Methods The design of the study was cross‐sectional. S erum anti‐ HEV IgG was determined by enzyme immunoassay in 238 HIV ‐infected patients consecutively attending our out‐patient clinic between A pril and M ay 2011. In HEV ‐seropositive patients, HEV RNA was analysed by nested reverse transcriptase–polymerase chain reaction ( RT‐PCR ). Associations between anti‐ HEV and liver cirrhosis, route of HIV infection, hepatitis B virus ( HBV ) and hepatitis C virus ( HCV ) serological markers, age, sex and alanine aminotransferase ( ALT ) levels were examined by univariate and multivariate analysis. Results One hundred and forty patients (59%) had chronic liver disease (99% were HBV ‐ and/or HCV ‐coinfected). Liver cirrhosis was detected in 44 individuals (19%). Two hundred and twelve patients (89%) were on antiretroviral treatment; the median CD 4 T‐cell count was 483 cells/μ L [interquartile range ( IQR ) 313–662 cells/μ L ] and the HIV viral load was < 25 HIV ‐1 RNA copies/mL. Overall, 22 patients (9%) were anti‐ HEV positive. Liver cirrhosis was the only factor independently associated with the presence of anti‐ HEV , which was documented in 23% of patients with cirrhosis and 6% of patients without cirrhosis ( P = 0.002; odds ratio 5.77). HEV RNA was detected in three seropositive patients (14%), two of whom had liver cirrhosis. Conclusions Our findings show a high prevalence of anti‐ HEV in HIV ‐infected patients, strongly associated with liver cirrhosis. Chronic HEV infection was detected in a significant number of HEV ‐seropositive patients. Further research is needed to ascertain whether cirrhosis is a predisposing factor for HEV infection and to assess the role of chronic HEV infection in the pathogeneses of cirrhosis in this population.