López-López Pedro, Rivero-Juarez Antonio, Frias Mario, Machuca Isabel, Caballero-Gómez Javier, Olivas Israel, Camacho Angela, Risalde María de Los Angeles, García-Bocanegra Ignacio, Rivero Antonio
Infectious Diseases Unit, Hospital Universitario Reina Sofía de Córdoba, Instituto Maimonides de Investigación Biomédica de Córdoba, University of Córdoba, Córdoba, Spain.
Department of Animal Health, University of Córdoba, Córdoba, Spain.
Front Microbiol. 2019 Nov 7;10:2617. doi: 10.3389/fmicb.2019.02617. eCollection 2019.
Mutations in the progesterone receptor (PR) gene, PROGINS, have been studied in relation to hepatitis E virus (HEV) infection. Patients with the PROGINS gene may develop a worse clinical course of hepatitis E. The aim of our study was to evaluate the influence of PROGINS on the susceptibility to and the clinical course of HEV infection in HIV patients.
This study included patients with HIV who were evaluated in previous prospective studies for the prevalence and incidence of HEV. The following three groups of patients were studied: (i) never infected, (ii) past infections, and (iii) recently infected. We determined the PR genotype to evaluate the proportion of patients who were homozygous for PROGINS according to HEV infection. We also compared the proportion of PROGINS carriers with a recent HEV infection according to their symptomatology.
In this study, 311 patients infected with HIV were included. Of those patients, 198 were homozygous wild type (63.7%), 91 were heterozygous (29.3%), and 22 were homozygous PROGINS (7.1%). We found that the homozygous PROGINS genotype in women was associated with a lower HEV seroprevalence. In addition, in patients with a recent HEV infection, none of those homozygous for PROGINS presented symptoms.
The PROGINS mutation plays a protective role against HEV infection and is associated with subclinical infection in HIV-infected patients, particularly women.
已对孕激素受体（PR）基因PROGINS的突变与戊型肝炎病毒（HEV）感染的关系进行了研究。携带PROGINS基因的患者戊型肝炎的临床病程可能更严重。我们研究的目的是评估PROGINS对HIV患者感染HEV的易感性及临床病程的影响。
本研究纳入了在既往前瞻性研究中评估过HEV患病率和发病率的HIV患者。研究了以下三组患者：（i）从未感染过，（ii）既往感染过，（iii）近期感染过。我们确定PR基因型，以评估根据HEV感染情况纯合子携带PROGINS的患者比例。我们还根据症状比较了近期感染HEV的PROGINS携带者的比例。
本研究纳入了311例感染HIV的患者。其中，198例为纯合野生型（63.7%），91例为杂合子（29.3%），22例为纯合PROGINS（7.1%）。我们发现女性中的纯合PROGINS基因型与较低的HEV血清阳性率相关。此外，在近期感染HEV的患者中，纯合PROGINS的患者均未出现症状。
PROGINS突变对HEV感染起保护作用，且与HIV感染患者（尤其是女性）的亚临床感染有关。
