title: Prevalence of antibodies and RNA genome of hepatitis E virus in a cohort of French immunocompromised.
abstract: BACKGROUND
  Recently, cases of chronic hepatitis E have been identified in immunocompromised patients.
  
  
  OBJECTIVE
  To evaluate the prevalence of anti-HEV IgG antibodies and the persistence of HEV-RNA in sera of immunocompromised patients with regular follow-up at Saint-Louis Hospital in Paris, France.
  
  
  METHODS
  307 samples collected from 261 HIV-infected patients and 46 kidney transplant (KT)-patients were retrospectively tested for the presence of the following hepatitis E virus (HEV) infection markers: anti-HEV IgM antibodies, anti-HEV IgG antibodies, anti-HEV IgG avidity index, and HEV-RNA.
  
  
  RESULTS
  Anti-HEV IgG positive serology was found in 4 HIV-infected patients (1.5%) and 3 KT-patients (6.5%), leading to an overall seroprevalence of 2.3%. HEV-RNA detection was not observed among 55 HIV-patients at higher risk of chronic HEV (<200 CD4 cells/mm(3), elevated alanine aminotransferase (ALT) levels, and/or positive anti-HEV antibodies) and among 44 KT-patients. None of the seven patients had anti-HEV IgM antibodies, thereby excluding any acute infection. The IgG avidity index confirmed past HEV infection among tested patients.
  
  
  CONCLUSIONS
  The low seroprevalence observed in the Paris region does not warrant a systematic evaluation of HEV infection in immunocompromised patients. However, HEV infection must be examined as a possibility if unexplained increases in ALT should occur and after more common viral hepatitis infections are excluded.
authors.affiliation: Virology Dpt, Inserm U941-Paris 7 Diderot University, Saint-Louis Hospital-APHP, Paris, France. sarah.maylin@sls.aphp.fr
authors.forename: Sarah
authors.initials: S
authors.lastname: Maylin
authors.forename: Robin
authors.initials: R
authors.lastname: Stephan
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Molina
authors.forename: Marie-Noelle
authors.initials: MN
authors.lastname: Peraldi
authors.forename: Catherine
authors.initials: C
authors.lastname: Scieux
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Nicand
authors.forename: François
authors.initials: F
authors.lastname: Simon
authors.forename: Constance
authors.initials: C
authors.lastname: Delaugerre
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D016679:Genome, Viral; D006508:Hepatitis Antibodies / Q000097:blood*; D016751:Hepatitis E / Q000453:epidemiology* / Q000821:virology; D016752:Hepatitis E virus / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D006521:Hepatitis, Chronic; D006801:Humans; D016867:Immunocompromised Host; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood*; D014505:Urban Population
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral