title: Hepatitis E prevalence among HIV infected patients with elevated liver enzymes in the Netherlands.
abstract: BACKGROUND
  In recent years chronic hepatitis E virus (HEV) infections have been reported in immunosuppressed patients, including HIV-positive patients with low CD4 cell counts. Because of delayed anti-HEV seroconversion in patients with CD4 cell count<200 cells/ml it is difficult to draw firm conclusions on HEV-seroprevalence in a population of HIV positive patients.
  
  
  OBJECTIVE
  To determine the HEV seroprevalence in a population of HIV infected patients.
  
  
  METHODS
  We retrospectively analysed the HEV prevalence in a population of 256 HIV infected patients with liver enzyme elevations (LEEs), using HEV specific antibody testing and HEV-RNA detection.
  
  
  RESULTS
  Within this cohort we observed a HEV-seroprevalence of 11.7%, without any anti-HEV IgM positive or HEV-RNA positive cases. HEV seropositivity was equally prevalent among different CD4(+) cell count groups.
  
  
  CONCLUSIONS
  Although HIV infected patients in the Netherlands are at risk of acquiring HEV, the number of acute infections is low and no chronic cases were found.
authors.affiliation: Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands; Inspectorate of Health Care, The Hague, The Netherlands. Electronic address: r.hassing@erasmusmc.nl.
authors.forename: R J
authors.initials: RJ
authors.lastname: Hassing
authors.affiliation: Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: a.vandereijk@erasmusmc.nl.
authors.forename: A A
authors.initials: AA
authors.lastname: van der Eijk
authors.affiliation: Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: VBaptistaLopes@amphia.nl.
authors.forename: V Baptista
authors.initials: VB
authors.lastname: Lopes
authors.affiliation: Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: isnijdewind@gmail.com.
authors.forename: I J
authors.initials: IJ
authors.lastname: Snijdewind
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: r.deman@erasmusmc.nl.
authors.forename: R A
authors.initials: RA
authors.lastname: de Man
authors.affiliation: Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: s.pas@erasmusmc.nl.
authors.forename: S D
authors.initials: SD
authors.lastname: Pas
authors.affiliation: Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: m.vanderende@erasmusmc.nl.
authors.forename: M E
authors.initials: ME
authors.lastname: van der Ende
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000914:Antibodies, Viral / Q000276:immunology; D001219:Aspartate Aminotransferases / Q000097:blood; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology; D015497:HIV-1 / Q000276:immunology; D016751:Hepatitis E / Q000453:epidemiology* / Q000235:genetics / Q000276:immunology*; D016752:Hepatitis E virus / Q000276:immunology*; D006801:Humans; D007118:Immunoassay; D007075:Immunoglobulin M / Q000276:immunology; D008099:Liver / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D014766:Viremia / Q000097:blood
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D012367:RNA, Viral; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: HIV; Hepatitis E; Seroprevalence