title: Hepatitis E virus in HIV-infected patients.
abstract: OBJECTIVE
  Many cases of acute autochthonous hepatitic E virus (HEV) hepatitis have been reported in France, mainly from the south. Chronic HEV infection has recently been described in immunosuppressed patients. Although a potential risk of chronicity exists in HIV-infected patients, no survey has been conducted in this population. The aim of this study was to assess the sero-virological prevalence of HEV in French HIV-infected patients.
  
  
  METHODS
  Two hundred and forty-five HIV-infected patients followed at two Infectious Diseases Departments (one in the south, one in the north) were included from January to March 2009. Sera were collected from all patients and tested using anti-HEV IgG and IgM kits. HEV RNA was systematically amplified in the ORF2 region with an in-house method. The IgG avidity index of all IgG-positive samples was determined.
  
  
  RESULTS
  Three of the 133 southern patients showed both anti-HEV IgG and IgM positivities, along with cytolysis and biological cholestasis; HEV RNA was amplified in two of these cases, whereas a low IgG avidity index was observed in all three samples. Twelve of the 130 remaining southern patients (9%) showed anti-HEV IgG positivity. The serological prevalence in the 112 northern patients was 3%, which was significantly lower than in the southern patients (P=0.04). No case of acute hepatitis was reported in the north, whereas the prevalence of patients with biochemical liver abnormalities was similar in both areas (P=0.22).
  
  
  CONCLUSIONS
  In France, HIV-infected patients are at risk of HEV infection with a serological north-to-south gradient. No case of chronic HEV infection was detected in this study.
authors.affiliation: Hôpital de jour, Centre Hospitalier, Hyères, France. crenou@ch-hyeres.fr
authors.forename: Christophe
authors.initials: C
authors.lastname: Renou
authors.forename: Alain
authors.initials: A
authors.lastname: Lafeuillade
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Cadranel
authors.forename: Nicole
authors.initials: N
authors.lastname: Pavio
authors.forename: Alexandre
authors.initials: A
authors.lastname: Pariente
authors.forename: Thierry
authors.initials: T
authors.lastname: Allègre
authors.forename: Cécile
authors.initials: C
authors.lastname: Poggi
authors.forename: Guillaume
authors.initials: G
authors.lastname: Pénaranda
authors.forename: François
authors.initials: F
authors.lastname: Cordier
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Nicand
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000821:virology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000821:virology; D002908:Chronic Disease; D005260:Female; D005602:France; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000276:immunology; D016751:Hepatitis E / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D016752:Hepatitis E virus / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D012367:RNA, Viral