Filipe Rita, Prista-Leão Beatriz, Silva-Pinto André, Abreu Isabel, Serrão Rosário, Costa Rosário, Guedes Edite, Sobrinho-Simões Joana, Sarmento António, Koch Carmo, Santos Lurdes
Infectious Diseases Department Centro Hospitalar Universitário de São João Porto Portugal.
Faculty of Medicine University of Porto Porto Portugal.
Health Sci Rep. 2022 May 20;5(3):e624. doi: 10.1002/hsr2.624. eCollection 2022 May.
Hepatitis E virus (HEV) infection causes zoonotic hepatitis in Europe, with a higher risk of complications in immunocompromised hosts. HEV natural history in human immunodeficiency virus (HIV) positive patients is not fully understood, and its prevalence is unknown.
To study the seroprevalence of HEV and prevalence of chronic HEV in HIV-positive patients from Porto, Portugal.
We randomly selected patients from the cohort of HIV-positive patients followed in our hospital. We performed an enzyme-linked immunosorbent assay to search for immunoglobulin G for HEV. When the absorbance/cut-off was inferior to 3.5, the test was repeated, and a confirmatory test executed in that sample. For reactive tests and for immunosuppressed patients (CD4 count < 200/mm) with nonreactive test, a polymerase chain reaction (PCR) test was also performed.
We included 299 patients. The mean age was 48 and 75.3% were men. Regarding HIV infection, the median follow-up time was 10 years, the acquisition was mainly heterosexual contact, and 94% were on antiretroviral therapy. Seventy-six patients (25.4%) had reactive immunoglobulin G (IgG) hepatitis E serology. Patients with a reactive test were older (statistically significant difference). Otherwise, there was no difference between groups concerning birthplace, rural residence, chronic viral hepatitis coinfection, or cirrhosis. Nadir and actual T lymphocyte counts did not differ significantly from patients with HEV reactive and nonreactive serology. Gamma-glutamyl-transferase (GGT) was higher in patients with reactive IgG HEV. All serum HEV PCR tests were negative.
Seroprevalence of HEV was 25.4% in HIV-positive patients. Older age and higher GGT correlated to HEV reactive IgG test. No cases of current hepatitis E were found.
戊型肝炎病毒（HEV）感染在欧洲可导致人畜共患性肝炎，在免疫功能低下的宿主中发生并发症的风险更高。人类免疫缺陷病毒（HIV）阳性患者中HEV的自然病史尚未完全明确，其患病率也不清楚。
研究葡萄牙波尔图HIV阳性患者中HEV的血清学患病率及慢性HEV的患病率。
我们从本院随访的HIV阳性患者队列中随机选取患者。我们进行酶联免疫吸附试验以检测抗HEV免疫球蛋白G。当吸光度/临界值低于3.5时，重复该检测，并对该样本进行确证试验。对于反应性检测以及检测结果为非反应性的免疫抑制患者（CD4计数<200/mm），也进行聚合酶链反应（PCR）检测。
我们纳入了299例患者。平均年龄为48岁，75.3%为男性。关于HIV感染，中位随访时间为10年，感染主要通过异性接触获得，94%的患者正在接受抗逆转录病毒治疗。76例患者（25.4%）抗HEV免疫球蛋白G（IgG）血清学检测呈反应性。检测呈反应性的患者年龄更大（有统计学显著差异）。此外，在出生地、农村居住情况、慢性病毒性肝炎合并感染或肝硬化方面，各组之间没有差异。HEV血清学反应性和非反应性患者的最低和实际T淋巴细胞计数没有显著差异。反应性IgG HEV患者的γ-谷氨酰转移酶（GGT）更高。所有血清HEV PCR检测均为阴性。
HIV阳性患者中HEV的血清学患病率为25.4%。年龄较大和GGT较高与HEV反应性IgG检测相关。未发现当前戊型肝炎病例。
