Viera-Segura Oliver, Duarte-López Ilsy X, Loera-Robles Isidro, Singh-Ríos Norberto, Calderón-Flores Arturo, Copado-Villagrana Edgar D, Fierro Nora A
Instituto en Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico.
Unidad de Medicina Familiar 5, Instituto Mexicano del Seguro Social, Nogales 84000, Mexico.
Pathogens. 2025 Apr 26;14(5):420. doi: 10.3390/pathogens14050420.
Hepatitis E virus (HEV), the causative agent of hepatitis E, is the leading cause of acute viral hepatitis worldwide; under immunosuppression, infection can lead to chronic liver disease. Furthermore, extrahepatic manifestations, particularly renal manifestations, are frequently associated with infection. This is important considering the global burden of chronic kidney disease (CKD). However, the study of chronic hepatitis E has been limited to liver disease, and its definition with respect to renal disease is still incomplete. Recently, through a protocol aimed at identifying HEV seroprevalence in a cohort of patients on hemodialysis, we incidentally identified HEV RNA in a patient with a history of alcoholism, diabetes mellitus, and essential systemic hypertension. In this study, we aimed to follow up this case to characterize hepatitis E in the context of CKD. Notably, we identified the development of chronic HEV genotype 3 infection without seroconversion or evidence of liver damage. Moreover, apparent immunocompetence was identified in the patient. Considering that HEV is still neglected in numerous countries and that it is not included in the differential diagnosis of kidney disease, our findings support the need to consider HEV infection in patients with renal disease, even in the absence of liver deterioration.
戊型肝炎病毒（HEV）是戊型肝炎的病原体，是全球急性病毒性肝炎的主要病因；在免疫抑制情况下，感染可导致慢性肝病。此外，肝外表现，尤其是肾脏表现，常与感染相关。鉴于慢性肾脏病（CKD）的全球负担，这一点很重要。然而，对慢性戊型肝炎的研究一直局限于肝脏疾病，其在肾脏疾病方面的定义仍不完整。最近，通过一项旨在确定一组血液透析患者中HEV血清流行率的方案，我们偶然在一名有酗酒、糖尿病和原发性全身性高血压病史的患者中发现了HEV RNA。在本研究中，我们旨在对该病例进行随访，以在CKD背景下对戊型肝炎进行特征描述。值得注意的是，我们发现了慢性HEV 3型感染的发展，且无血清转化或肝损伤证据。此外，该患者表现出明显的免疫能力。鉴于在许多国家HEV仍被忽视，且它未被纳入肾脏疾病的鉴别诊断中，我们的研究结果支持在肾病患者中考虑HEV感染的必要性，即使在没有肝脏恶化的情况下。
