title: Hepatitis E virus co-infection in HIV-infected patients in Foggia and Naples in southern Italy.
abstract: BACKGROUND
  Hepatitis E virus (HEV) infection represents an emerging infection in developed countries and is thought to be a zoonotic infection. It has recently been described as a new causative agent of acute and chronic hepatitis in immunosuppressed subjects, including HIV-infected patients. The aim of this study was to assess the sero-virological prevalence of HEV in HIV patients and in the general population as control group.
  
  
  METHODS
  A prospective and observational cohort study was carried out in two hospitals in southern Italy. The seroprevalence of HEV was determined in a cohort of 959 subjects, 509 (53%) of whom were HIV-positive patients and 450 were from the general population. Serum samples were tested for anti-HEV antibodies; repeatedly positive results were confirmed by a Western blot assay. In positive patients HEV RNA and genotypes were also determined.
  
  
  RESULTS
  A total of 46 (4.8%) of the 959 serum samples examined were reactive to anti-HEV Ig and confirmed by Western blotting. The prevalence of HEV antibodies (IgG and/or IgM) was 2.7% in the control group and 6.7% in HIV-infected patients. Anti-HEV IgM was found in 6/46 (13.0%) of the anti-HEV Ig-positive serum samples, in 5/34 HIV patients and in 1/12 of the general population. No HIV-infected patient presented chronic hepatitis with HEV infection alone.
  
  
  CONCLUSIONS
  This study indicates a higher circulation of HEV in HIV-infected patients, whereas a low prevalence of HEV antibodies in the general Italian population was shown. Chronic hepatitis with HEV alone was absent, while it was present in subjects with HIV-HEV, co-infected with hepatitis B virus (HBV) and/or hepatitis C virus (HCV).
authors.affiliation: From the 1 Chair of Microbiology and Clinical Microbiology, University of Foggia , Foggia , Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Scotto
authors.forename: Benvenuto
authors.initials: B
authors.lastname: Grisorio
authors.forename: Pietro
authors.initials: P
authors.lastname: Filippini
authors.forename: Sergio
authors.initials: S
authors.lastname: Ferrara
authors.forename: Salvatore
authors.initials: S
authors.lastname: Massa
authors.forename: Fabio
authors.initials: F
authors.lastname: Bulla
authors.forename: Salvatore
authors.initials: S
authors.lastname: Martini
authors.forename: Alberico
authors.initials: A
authors.lastname: Filippini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Tartaglia
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Lo Muzio
authors.forename: Vincenzina
authors.initials: V
authors.lastname: Fazio
mesh_terms: D000328:Adult; D015153:Blotting, Western; D015331:Cohort Studies; D060085:Coinfection; D005260:Female; D006678:HIV / Q000502:physiology; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006508:Hepatitis Antibodies / Q000097:blood*; D016751:Hepatitis E / Q000150:complications* / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D016752:Hepatitis E virus / Q000276:immunology* / Q000302:isolation & purification* / Q000502:physiology; D006521:Hepatitis, Chronic / Q000150:complications / Q000276:immunology / Q000821:virology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood / Q000302:isolation & purification; D007558:Italy / Q000453:epidemiology; D008099:Liver / Q000503:physiopathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D016036:Seroepidemiologic Studies
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral
keywords: HIV infection; Hepatitis E; co-infection HBV-HCV; epidemiology; seroprevalence