title: Hepatitis E virus seroprevalence among schistosomiasis patients in Northeastern Brazil.
abstract: BACKGROUND
  Hepatitis E virus (HEV) can cause chronic infection with rapid progression to liver cirrhosis in immunocompromised patients. HEV seroprevalence in patients with Schistosoma mansoni in Brazil is unknown. We evaluated the prevalence of past or present HEV infection in schistosomiasis patients in Recife, Pernambuco, Brazil. A total of 80 patients with Schistosoma mansoni were consecutively enrolled in a cross-sectional study. Serum samples were tested for the presence of anti-HEV IgG antibodies by enzyme immunoassay (Wantai anti-HEV IgG, Beijing, China) and for the presence of HEV RNA using real time reverse transcriptase-polymerase chain reaction with primers targeting the HEV ORF2 and ORF3. Clinical and laboratory tests as well as abdominal ultrasound were performed at the same day of blood collection.
  
  
  RESULTS
  Anti-HEV IgG was positive in 18.8% (15/80) of patients with SM. None of the samples tested positive for anti-HEV IgM or HEV-RNA. Patients with anti-HEV IgG positive presented higher levels of alanine aminotranferase (p=0.048) and gama-glutamil transferase (p=0.022) when compared to patients without anti-HEV IgG antibodies.
  
  
  CONCLUSIONS
  This study demonstrates that the seroprevalence of HEV is high in patients with Schistosoma mansoni in Northeastern of Brazil. Past HEV infection is associated with higher frequency of liver enzymes abnormalities. HEV infection and its role on the severity of liver disease should be further investigated among patients with Schistosoma mansoni.
authors.affiliation: Division of Infectious Diseases, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Passos-Castilho
authors.affiliation: Division of Infectious Diseases, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil; Fleury SA Group, Brazil.
authors.forename: Anne
authors.initials: A
authors.lastname: de Sena
authors.affiliation: Division of Gastroenterology, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.
authors.forename: Ana Lucia Coutinho
authors.initials: AL
authors.lastname: Domingues
authors.affiliation: Division of Gastroenterology, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.
authors.forename: Edmundo Pessoa
authors.initials: EP
authors.lastname: Lopes-Neto
authors.affiliation: Division of Gastroenterology, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.
authors.forename: Tibério Batista
authors.initials: TB
authors.lastname: Medeiros
authors.affiliation: Division of Infectious Diseases, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil; Fleury SA Group, Brazil.
authors.forename: Celso Francisco Hernandez
authors.initials: CF
authors.lastname: Granato
authors.affiliation: Division of Gastroenterology, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil. Electronic address: marialucia.ferraz@uol.com.br.
authors.forename: Maria Lúcia
authors.initials: ML
authors.lastname: Ferraz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D016752:Hepatitis E virus / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012555:Schistosomiasis mansoni / Q000150:complications / Q000453:epidemiology*; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M
keywords: Brazil; Epidemiology; Hepatitis E virus; Schistosomiasis; Seroprevalence