Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
J Med Virol. 2014 Jan;86(1):71-4. doi: 10.1002/jmv.23804. Epub 2013 Oct 17.
Hepatitis E virus is responsible for sporadic cases of acute, self-limited viral hepatitis not only in endemic but also in industrialized countries. In addition, some reports confirm that it can cause chronic infection and even cirrhosis in immunosuppressed and also in patients infected with HIV. There are few data about prevalence and incidence of HEV chronic infection in HIV-HEV coinfected individuals in Spain. The aim of this study is to investigate the prevalence of anti-HEV IgG in a representative sample of 448 patients infected with HIV and determine the role of age, gender, and CD4 counts in the detection of anti-HEV IgG antibodies in blood. In addition, the clinical features and ALT levels in relation to the presence of anti-HEV IgM and/or HEV-RNA in the blood of these patients were investigated. Anti-HEV IgG antibodies were detected in serum using a commercial enzyme immunoassay. All positive samples were studied further for the presence of anti-HEV IgM antibodies. In addition, HEV RNA was amplified by reverse transcriptase (RT)-nested PCR in all serum samples with IgM anti-HEV. The overall prevalence of anti-HEV IgG was 10.4% (45/448, 95% C.I. 7.2-12.8%). HEV-RNA was found in only one patient out of the 45 anti-HEV IgG positive samples studied. Regarding to gender and CD4 count, no difference in seroprevalence could be observed. This prevalence data suggest that patients infected with HIV can be considered a risk group for HEV infection and that chronic coinfection HEV-HIV seems to be a very rare event.
戊型肝炎病毒不仅在流行地区，而且在工业化国家，也可引起散发性、自限性急性病毒性肝炎。此外，一些报道证实，它可在免疫抑制患者中引起慢性感染，甚至导致肝硬化，也可在感染 HIV 的患者中引起慢性感染。关于西班牙 HIV-HEV 合并感染患者中 HEV 慢性感染的流行率和发病率，数据较少。本研究的目的是调查在 448 例 HIV 感染患者的代表性样本中抗-HEV IgG 的流行率，并确定年龄、性别和 CD4 计数在血液中检测抗-HEV IgG 抗体中的作用。此外，还研究了这些患者血液中抗-HEV IgM 和/或 HEV-RNA 存在时的临床特征和 ALT 水平。使用商业酶免疫测定法检测血清中的抗-HEV IgG 抗体。对所有阳性样本进一步研究是否存在抗-HEV IgM 抗体。此外，所有抗-HEV IgM 阳性的血清样本均采用逆转录酶（RT）-巢式 PCR 扩增 HEV RNA。抗-HEV IgG 的总流行率为 10.4%（45/448，95%置信区间 7.2-12.8%）。在研究的 45 例抗-HEV IgG 阳性样本中，仅发现 1 例患者存在 HEV-RNA。关于性别和 CD4 计数，未观察到血清阳性率的差异。这些流行率数据表明，感染 HIV 的患者可被视为 HEV 感染的高危人群，并且慢性合并感染 HEV-HIV 似乎是一种非常罕见的事件。
