Rural habitat as risk factor for hepatitis E virus seroconversion in HIV ‐infected patients: A prospective longitudinal study

Summary Our objective was to determine the incidence and clinical manifestations of acute hepatitis E virus ( HEV ) in HIV ‐infected patients. A prospective longitudinal study including HIV ‐infected HEV ‐seronegative patients was conducted; HEV seroconversion (to IgG and/or IgM) was the main outcome variable. All patients were tested for HEV antibodies every 3–6 months. For patients who developed HEV seroconversion, a data collection protocol was followed to identify associated clinical manifestations and analytical alterations. A total of 627 patients (89.9%) were followed during a median of 11.96 months ( IQR : 8.52–14.52 months) and formed the study population. Forty‐one patients developed detectable anti‐ HEV antibodies (7.2 cases per 100 patients/year). Our study found a high incidence of HEV in HIV ‐infected patients in southern Spain strongly associated with a rural habitat.