title: Hepatitis E virus infection in patients infected with the human immunodeficiency virus.
abstract: Hepatitis E virus (HEV) is a newly-identified causative agent of acute and chronic hepatitis in severely immunocompromized patients. The present study sought to assess the prevalences of past, recent, on-going, and chronic HEV infections in patients infected with human immunodeficiency virus (HIV) in Marseille, South-eastern France, and to determine if they were correlated with the patients' immunological status or with cirrhosis. Anti-HEV IgG and IgM and HEV RNA testing were concurrently performed on the plasma from 184 patients infected with HIV, including 81 with a CD4+ T-lymphocyte count (CD4 count) <50 cells/mm(3) and 32 with a cirrhosis. Prevalence of anti-HEV IgG and IgM was 4.4% (8/184) and 1.6% (3/184), respectively. Past, recent, and on-going infections were observed in 3.3% (6/184), 1.6% (3/184), and 0.5% (1/184) of the patients, respectively. Anti-HEV antibodies prevalence did not differ significantly according to CD4 count, cirrhosis, sex, age, mode of HIV transmission, and infection with hepatitis B or C virus. Anti-HEV IgG seroreversion was observed in two patients. The patient whose plasma tested positive for HEV RNA had a CD4 count <50 cells/mm(3) ; HEV genotype was 3f. In this patient, longitudinal testing showed HEV RNA positivity during a 10-month period, indicating chronic HEV infection; in contrast, anti-HEV IgG never tested positive. Further studies are needed to evaluate the performance of commercial HEV serological assays in patients infected with HIV and to assess the actual incidence, prevalence, and outcome of HEV infection in this special group of patients. HEV RNA testing is necessary for such purposes.
authors.affiliation: Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Centre Hospitalo-Universitaire Timone, Marseille, France.
authors.forename: Mamadou
authors.initials: M
authors.lastname: Kaba
authors.forename: Hervé
authors.initials: H
authors.lastname: Richet
authors.forename: Isabelle
authors.initials: I
authors.lastname: Ravaux
authors.forename: Jacques
authors.initials: J
authors.lastname: Moreau
authors.forename: Isabelle
authors.initials: I
authors.lastname: Poizot-Martin
authors.forename: Anne
authors.initials: A
authors.lastname: Motte
authors.forename: Corinne
authors.initials: C
authors.lastname: Nicolino-Brunet
authors.forename: Françoise
authors.initials: F
authors.lastname: Dignat-George
authors.forename: Amélie
authors.initials: A
authors.lastname: Ménard
authors.forename: Catherine
authors.initials: C
authors.lastname: Dhiver
authors.forename: Philippe
authors.initials: P
authors.lastname: Brouqui
authors.forename: Philippe
authors.initials: P
authors.lastname: Colson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001483:Base Sequence; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D016752:Hepatitis E virus / Q000235:genetics / Q000276:immunology*; D006801:Humans; D016867:Immunocompromised Host; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008103:Liver Cirrhosis / Q000150:complications; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D012367:RNA, Viral / Q000097:blood; D017423:Sequence Analysis, RNA
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral