Persistent Carriage of Hepatitis E Virus in Patients with HIV Infection
New England Journal of Medicine (Impact Factor: 55.87). 10/2009; 361(10):1025-7. DOI: 10.1056/NEJMc0903778
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- "Pregnant women are vulnerable to fulminant courses (Boccia et al., 2006; Hamid et al., 2002). Chronic HEV infection may occur mainly in immunocompromised patients with HIV, organ transplants and during cancer chemotherapy (Dalton et al., 2009; Kamar et al., 2008). Large hepatitis E outbreaks with 120,000 cases occurred in China in 1986–1988 (Dalton et al., 2013), followed by N30,000 cases in India in 1956 (Shukla et al., 2011). "
ABSTRACT: Hepatitis E virus (HEV) infection may cause acute hepatitis and lead to hepatic failure in developing and developed countries. We studied HEV seroprevalences in patients with hepatitis B virus (HBV) infection to understand the consequences of HEV superinfection in a Vietnamese population. This cross-sectional study was conducted from 2012 to 2013 and included 1318 Vietnamese patients with HBV-related liver diseases and 340 healthy controls. The case group included patients with acute (n=26) and chronic hepatitis B (n=744), liver cirrhosis (n=160), hepatocellular carcinoma (n=166) and patients with both liver cirrhosis and hepatocellular carcinoma (n=222). Anti-HEV IgG and IgM antibodies were assessed in patients and controls by ELISA. HEV-RNA was identified by PCR assays and sequencing. Seroprevalences of anti-HEV IgG among hepatitis B patients and controls were 45% and 31%, respectively (adjusted P=0.034). Anti-HEV IgM seroprevalences were 11.6% and 4.7% in patients and controls, respectively (adjusted P=0.005). Seroprevalences were higher among the elder individuals. When stratifying for patient groups, those with liver cirrhosis had the highest anti-HEV IgG (52%) and anti-HEV IgM (19%) seroprevalences. Hepatitis B patients with current HEV infection had abnormal liver function tests compared to patients with past or without HEV infection. One HEV isolate was retrieved from a patient with both liver cirrhosis and hepatocellular carcinoma and identified as HEV genotype 3. This study indicates high prevalences of HEV infection in Vietnamese HBV patients and among healthy individuals and shows that HEV superinfection may influence the outcome and progression of HBV-related liver disease.11/2015; DOI:10.1016/j.ebiom.2015.11.020
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- "However, HEV infection may occasionally cause severe liver dysfunction, fulminant hepatitis, and liver failure in some patients with an underlying disease (Kamar et al., 2012; Suzuki et al., 2002). Furthermore, HEV genotype 3 can lead to chronic hepatitis and liver cirrhosis in immunocompromised patients such as solid-organ transplant (SOT) recipients (Kamar et al., 2008), patients with human immunodeficiency virus infection (Dalton et al., 2009), and patients with hematologic cancers receiving chemotherapy (Ollier et al., 2009). Various studies have investigated the presence of HEV infection in SOT recipients in European and American countries but not yet in Japan. "
ABSTRACT: Background: Recently, chronic hepatitis E has been increasingly reported in organ transplant recipients in European countries. In Japan, the prevalence of hepatitis E virus (HEV) infection after transplantation remains unclear, so we conducted a nationwide cross-sectional study to clarify the prevalence of chronic HEV infection in Japanese liver transplant recipients. Methods: A total of 1893 liver transplant recipients in 17 university hospitals in Japan were examined for the presence of immunoglobulin G (IgG), IgM and IgA classes of anti-HEV antibodies, and HEV RNA in serum. Findings: The prevalence of anti-HEV IgG, IgM and IgA class antibodies was 2.9% (54/1893), 0.05% (1/1893) and 0% (0/1893), respectively. Of 1651 patients tested for HEV RNA, two patients (0.12%) were found to be positive and developed chronic infection after liver transplantation. In both cases, HEV RNA was also detected in one of the blood products transfused at the perioperative period. Analysis of the HEV genomes revealed that the HEV isolates obtained from the recipients and the transfused blood products were identical in both cases, indicating transfusion-transmitted HEV infection. Interpretation: The prevalence of HEV antibodies in liver transplant recipients was 2.9%, which is low compared with the healthy population in Japan and with organ transplant recipients in European countries; however, the present study found, for the first time, two Japanese patients with chronic HEV infection that was acquired via blood transfusion during or after liver transplantation.09/2015; DOI:10.1016/j.ebiom.2015.09.030
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- "Most cases of acute hepatitis E are self-limiting, but mortality can reach up to 20% in pregnant women [Purcell and Emerson, 2008]. Chronic infection with hepatitis E occurs almost exclusively in immunocompromised individuals such as those who have undergone organ transplantation [Kamar et al., 2008], are receiving chemotherapy [Ollier et al., 2009] or are HIV-infected [Dalton et al., 2009]. "
ABSTRACT: HEV infection is an emerging public health problem worldwide Data concerning HEV infection in HIV+ patients in Greece is scare. The aim of the study was to determine HEV seroprevalence in patients with HIV infection in Greece. We studied 243 HIV(+) patients 214 men (88%) and 29 women (12%) with a median age of 45 years (range 19-83) who attended the HIV unit of Pathophysiology Department of Laikon General Hospital in Athens for the presence of anti-HEV IgG antibodies with (EIA) (EIA HEV IgG, Adaltis, Rome, Italy Eighteen/243 patients (7.3%) were positive for HEV IgG antibodies, a seroprevalence that was not different from that described for the blood donors group from Greece There was no difference of the presence of HbsAg, hepatitis C and hepatitis A between the HEV(+) and HEV(-) patients. There was no statistically significant difference between the HEV(+) and HEV(-) group in terms of HIV acquisition, sexual orientation, median duration of HIV infection, ART treatment, or duration of ART. Only the median age of HEV(+) was 52years (35-78) while that of HEV(-) was 44years (19-83)(P = 0.03). Only 2/18(11.1%) HEV(+) HIV(+) patients had abnormal ALT and AST values. The seroprevalence of hepatitis E in HIV(+) patients in Greece seems to be the same with that of the general population thus implying that HIV infection is not a risk factor for HEV infection and only age shows a positive correlation with seropositivity. J. Med. Virol. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.Journal of Medical Virology 05/2015; 87(9). DOI:10.1002/jmv.24214 · 2.35 Impact Factor
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