原因不明的肝病的HIV感染患者中戊型肝炎病毒抗体的高流行率。
High prevalence of antibodies against hepatitis E virus in HIV-infected patients with unexplained liver disease.
作者信息
Merchante Nicolás, Parra-Sánchez Manuel, Rivero-Juárez Antonio, Cifuentes Celia, Camacho Ángela, Macías Juan, Martínez-Dueñas Loreto, Pérez-Navarro Elisabet, Rivero Antonio, Pineda Juan A
机构信息
Unidad de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Sevilla, Spain.
Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.
出版信息
Enferm Infecc Microbiol Clin. 2015 Oct;33(8):532-5. doi: 10.1016/j.eimc.2014.10.018. Epub 2014 Dec 19.
OBJECTIVE
To look for evidence of hepatitis E virus (HEV) exposure in HIV-infected patients with unexplained elevations of liver stiffness (LS).
METHODS
Case-control study conducted in 31 HIV-infected patients with unexplained elevations of LS and in 31 HIV-controls with normal LS, matched by age, sex and CD4 cell-counts. Serum HEV antibodies were tested by two ELISA procedures and by Immunoblot. We defined exposure to HEV as the detection of serum HEV antibodies by at least one of the two ELISA assays, provided that it was confirmed by Immunoblot. A real-time PCR RNA assay was conducted in all plasma samples to identify subjects with active HEV infection.
RESULTS
Exposure to HEV was demonstrated, according to the criteria used in this study, in 9 (29%) of the cases, whereas it was shown in 5 (16%) of the controls (p=.3). Serum HEV RNA was detected in none of the controls and in only in one case. This patient had a documented chronic hepatitis E with progression to cirrhosis.
CONCLUSIONS
HEV antibodies are frequently found in HIV-infected patients with unexplained liver disease.
目的
在肝硬度（LS）原因不明升高的HIV感染患者中寻找戊型肝炎病毒（HEV）暴露的证据。
方法
对31例LS原因不明升高的HIV感染患者和31例LS正常的HIV对照者进行病例对照研究，根据年龄、性别和CD4细胞计数进行匹配。采用两种酶联免疫吸附测定（ELISA）方法和免疫印迹法检测血清HEV抗体。我们将HEV暴露定义为通过两种ELISA检测方法中的至少一种检测到血清HEV抗体，前提是经免疫印迹法确认。对所有血浆样本进行实时PCR RNA检测，以识别活动性HEV感染的受试者。
结果
根据本研究使用的标准，9例（29%）病例显示有HEV暴露，而对照组中有5例（16%）显示有HEV暴露（p = 0.3）。对照组中未检测到血清HEV RNA，仅1例病例检测到。该患者有记录的慢性戊型肝炎并进展为肝硬化。
结论
在肝疾病原因不明的HIV感染患者中经常发现HEV抗体。
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