van Gerven Nicole M F, van der Eijk Annemiek A, Pas Suzan D, Zaaijer Hans L, de Boer Ynto S, Witte Birgit I, van Nieuwkerk Carin M J, Mulder Chris J J, Bouma Gerd, de Man Robert A
Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, The Netherlands.
Department of Virology, Erasmus Medical Centre, Rotterdam, The Netherlands.
J Gastrointestin Liver Dis. 2016 Mar;25(1):9-13. doi: 10.15403/jgld.2014.1121.251.hpe.
In recent years chronic courses of hepatitis E virus (HEV) infection have been described in immunosuppressed individuals. This may implicate a potential role for HEV in the development of autoimmune diseases, including autoimmune hepatitis (AIH). Here we investigated the prevalence of HEV-antibodies in AIH patients in an endemic Central European country.
HEV-specific immunoglobulin G (IgG) and HEV RNA were determined in 354 and 377 AIH patients, respectively. Clinical characteristics and disease outcome parameters were retrospectively collected.
No HEV viraemic patients were identified in this cohort. A total of 106 AIH patients (29.9%) tested positive for anti-HEV IgG, and this figure was slightly higher compared to the prevalence in a reference cohort including 5,329 healthy Dutch blood donors (26.7%; P>0.05).
This is the largest study on the association between HEV infection and AIH. Apparently silent HEV infection is present in a significant proportion of AIH patients, yet appears not to have significant clinical repercussions in this immune compromised group of patients. Nevertheless, since acute hepatitis E may present with histological and biochemical features of AIH, the possibility of a (concomitant) HEV infection should be considered in this category of patients.
近年来，免疫功能低下个体中已出现戊型肝炎病毒（HEV）慢性感染病程的相关描述。这可能暗示HEV在自身免疫性疾病（包括自身免疫性肝炎，AIH）的发展中具有潜在作用。在此，我们调查了中欧一个地方性流行国家AIH患者中HEV抗体的流行情况。
分别对354例和377例AIH患者检测了HEV特异性免疫球蛋白G（IgG）和HEV RNA。回顾性收集了临床特征和疾病转归参数。
该队列中未发现HEV病毒血症患者。共有106例AIH患者（29.9%）抗HEV IgG检测呈阳性，这一数字略高于包括5329名荷兰健康献血者在内的对照队列中的流行率（26.7%；P>0.05）。
这是关于HEV感染与AIH之间关联的最大规模研究。相当比例的AIH患者存在看似无症状的HEV感染，但在这群免疫功能受损的患者中似乎没有显著的临床影响。然而，由于急性戊型肝炎可能表现出AIH的组织学和生化特征，对于此类患者应考虑（合并）HEV感染的可能性。
