Shah Shemal M, Baniya Jagat B, Gupta Birendra Prasad, Shrestha Ananta, Rodin Holly, Boonstra Andre, Debes Jose D
Department of Medicine, University of Minnesota.
Department of Microbiology, Kathmandu College of Science and Technology.
Eur J Gastroenterol Hepatol. 2019 Apr;31(4):503-505. doi: 10.1097/MEG.0000000000001308.
Hepatitis E virus (HEV) seropositivity may confer an increased risk of liver fibrosis in immunosuppressed individuals. We studied this effect in HIV-infected individuals in Nepal, a country hyperendemic for HEV.
We prospectively evaluated 200 HIV-positive individuals. Serum samples were tested for components of fibrosis scores and cytokeratin-18.
Of 200 patients, 43% were HEV-immunoglobulin G+. The mean fibrosis-4 score was 8.02 in the HEV-positive and 1.17 in the HEV-negative group (P<0.001). The mean nonalcoholic fatty liver disease score was 2.12 in the HEV-positive and -2.53 in the HEV-negative group (P=0.02). The mean aminotransferase-platelet ratio index score was 0.37 in the HEV-positive and 0.38 in the HEV-negative group (P=0.9). The mean cytokeratin-18 levels were 119.9 in the HEV-positive group and 158.6 in the HEV-negative group (P=0.08).
We found higher fibrosis-4 and nonalcoholic fatty liver disease scores in HEV-HIV-positive individuals, suggesting an increased liver fibrosis profile in this group. Further studies using liver stiffness measurements should be carried out.
戊型肝炎病毒（HEV）血清阳性可能会增加免疫抑制个体发生肝纤维化的风险。我们在尼泊尔的HIV感染者中研究了这种影响，尼泊尔是一个戊型肝炎病毒高度流行的国家。
我们前瞻性地评估了200名HIV阳性个体。检测血清样本中的纤维化评分成分和细胞角蛋白-18。
200例患者中，43%为HEV免疫球蛋白G阳性。HEV阳性组的纤维化-4平均评分为8.02，HEV阴性组为1.17（P<0.001）。HEV阳性组的非酒精性脂肪性肝病平均评分为2.12，HEV阴性组为-2.53（P=0.02）。HEV阳性组的平均转氨酶-血小板比率指数评分为0.37，HEV阴性组为0.38（P=0.9）。HEV阳性组的平均细胞角蛋白-18水平为119.9，HEV阴性组为158.6（P=0.08）。
我们发现HEV-HIV阳性个体的纤维化-4和非酒精性脂肪性肝病评分更高，表明该组肝纤维化程度增加。应使用肝脏硬度测量进行进一步研究。
