Laboratorio de Referencia e Investigación en Hepatitis Víricas, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
Unidad de Enfermedades Infecciosas/VIH, Hospital General Universitario "Gregorio Marañón", Madrid, Spain.
Sci Rep. 2019 Feb 4;9(1):1143. doi: 10.1038/s41598-018-37328-6.
Hepatitis E virus (HEV) has emerged as a relevant pathogen for HIV-infected patients. However, there is scarce data on HEV infection in HIV/HCV-coinfected individuals with advanced fibrosis, which seems to increase the risk of HEV infection and worsen the prognosis of liver disease. We aimed to determine the prevalence of anti-HEV antibodies, acute hepatitis E, resolved hepatitis E, and exposure to HEV in HIV/HCV-coinfected patients and to evaluate associations with clinical and epidemiological characteristics. We performed a cross-sectional study on 198 HIV/HCV-coinfected patients, 30 healthy controls and 36 HIV-monoinfected patients. We found a low concordance between techniques used for detection of anti-HEV antibodies (ELISA versus Immunoblot), particularly in HIV/HCV-coinfected patients. HIV/HCV-coinfected patients showed the highest prevalence of IgG against HEV, resolved hepatitis E, and exposure to HEV (19.2%, 17.2%, and 22.2% respectively). However, we did not find any samples positive for HEV-RNA nor significant differences between groups. Moreover, HIV/HCV-coinfected patients with CD4 T-cells <350 cells/mm had higher prevalence for anti-HEV IgG antibodies, resolved hepatitis E, and exposure to HEV than healthy controls or those with CD4 T-cells ≥ 350 cells/mm (p = 0.034, p = 0.035, and p = 0.053; respectively). In conclusion, HIV/HCV-coinfected patients in Spain have a high prevalence for IgG anti-HEV antibodies, resolved hepatitis E, and exposure to HEV; particularly patients with CD4+T-cells <350 cells/mm.
戊型肝炎病毒 (HEV) 已成为感染 HIV 患者的相关病原体。然而，关于合并 HIV/HCV 感染且有晚期纤维化的个体中 HEV 感染的数据却很少，这似乎会增加 HEV 感染的风险并使肝病的预后恶化。我们旨在确定 HIV/HCV 合并感染患者中抗 HEV 抗体、急性戊型肝炎、已解决的戊型肝炎和 HEV 暴露的流行率，并评估其与临床和流行病学特征的相关性。我们对 198 例 HIV/HCV 合并感染患者、30 名健康对照者和 36 名 HIV 单感染患者进行了横断面研究。我们发现用于检测抗 HEV 抗体的技术（ELISA 与免疫印迹）之间的一致性较低，尤其是在 HIV/HCV 合并感染患者中。HIV/HCV 合并感染患者的 HEV 抗体 IgG 阳性率、已解决的戊型肝炎和 HEV 暴露率最高（分别为 19.2%、17.2%和 22.2%）。然而，我们没有发现任何 HEV-RNA 阳性样本，各组之间也没有显著差异。此外，CD4 T 细胞<350 个/mm 的 HIV/HCV 合并感染患者的抗 HEV IgG 抗体、已解决的戊型肝炎和 HEV 暴露率高于健康对照者或 CD4 T 细胞≥350 个/mm 的患者（p=0.034、p=0.035 和 p=0.053；分别）。总之，西班牙的 HIV/HCV 合并感染患者中，抗 HEV IgG 抗体、已解决的戊型肝炎和 HEV 暴露的流行率较高；尤其是 CD4+T 细胞<350 个/mm 的患者。
