Serological and molecular markers of hepatitis E virus infection in HIV-infected patients in Brazil
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In Brazil, the circulation of hepatitis E virus (HEV) has been demonstrated in distinct groups of individuals and some animals, but its prevalence among individuals with human immunodeficiency virus (HIV) infection is unknown. This study aimed to assess the frequency of serological and molecular HEV markers in individuals infected with HIV from São Paulo, Brazil. Serum and plasma samples of 354 HIV-infected patients collected between 2007 and 2013 were included. All samples were tested for anti-HEV IgG and IgM antibodies and HEV RNA. Anti-HEV IgG and IgM antibodies were detected in 10.7% (38/354) and 1.4% (5/354) of the samples, respectively. Both antibodies were detected simultaneously in only two samples. HEV RNA was not detected in any sample. There was no significant correlation of anti-HEV serological status (positivity to anti-HEV IgG and/or IgM) with sex, age, CD4+ T cell count, HIV viral load, antiretroviral therapy, liver enzyme levels, or coinfection with hepatitis B virus and/or hepatitis C virus. Our study provides serological evidence of past and recent HEV infections in HIV-infected patients from São Paulo, Brazil. However, the occurrence of ongoing HEV infection appears be a rare event in this population.
We would like to thank all patients who participated in the study.
Compliance with ethical standards
This study was supported by grant 2012/50504-2 from the São Paulo Research Foundation (FAPESP) and Alves de Queiroz Family Fund for Research. Ariana Carolina Ferreira is a graduate student from the Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil, and received a fellowship from FAPESP (2012/21588-3) and CAPES. João Renato Rebello Pinho and Maria Cássia Mendes Correa received a fellowship from CNPq (Bolsista de Produtividade em Pesquisa do CNPq - Nível 2).
Conflict of interest
João Renato Rebello Pinho is an employee of Albert Einstein Medicina Diagnóstica, São Paulo, Brazil. All other authors who took part in this study declare that they have no conflicts of interest or disclosures with respect to the manuscript.
All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
All participants provided written informed consent prior to enrollment in the study.
- 7.da Costa Lana MV, Gardinali NR, da Cruz RA, Lopes LL, Silva GS, Caramori Junior JG, de Oliveira AC, de Almeida Souza M, Colodel EM, Alfieri AA, Pescador CA (2014) Evaluation of hepatitis E virus infection between different production systems of pigs in Brazil. Trop Anim Health Prod 46:399–404CrossRefPubMedGoogle Scholar
- 11.de Souza AJ, Gomes-Gouvêa MS, Soares Mdo C, Pinho JR, Malheiros AP, Carneiro LA, dos Santos DR, Pereira WL (2012) HEV infection in swine from Eastern Brazilian Amazon: evidence of co-infection by different subtypes. Comp Immunol Microbiol Infect Dis 35:477–485Google Scholar
- 12.Debes JD, Martinez Wassaf M, Pisano MB, Isa MB, Lotto M, Marianelli LG, Frassone N, Ballari E, Bohjanen PR, Hansen BE, Re V (2016) Increased hepatitis E virus seroprevalence correlates with lower CD4+ cell counts in HIV-infected persons in Argentina. PLoS One 11:e0160082CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Fainboim H, Gonzalez J, Fassio E, Martinez A, Otegui L, Eposto M, Cahn P, Marino R, Landeira G, Suaya G, Gancedo E, Castro R, Brajterman L, Laplume H (1999) Prevalence of hepatitis viruses in an anti-human immunodeficiency virus-positive population from Argentina. A multicentre study. J Viral Hepat 6:53–57CrossRefPubMedGoogle Scholar
- 16.Feldt T, Sarfo FS, Zoufaly A, Phillips RO, Burchard G, van Lunzen J, Jochum J, Chadwick D, Awasom C, Claussen L, Drosten C, Drexler JF, Eis-Hubinger AM (2013) Hepatitis E virus infections in HIV-infected patients in Ghana and Cameroon. J Clin Virol Off Publ Pan Am Soc Clin Virol 58:18–23CrossRefGoogle Scholar
- 22.Haagsma EB, van den Berg AP, Porte RJ, Benne CA, Vennema H, Reimerink JH, Koopmans MP (2008) Chronic hepatitis E virus infection in liver transplant recipients. Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc 14:547–553Google Scholar
- 23.Hartl J, Otto B, Madden RG, Webb G, Woolson KL, Kriston L, Vettorazzi E, Lohse AW, Dalton HR, Pischke S (2016) Hepatitis E seroprevalence in Europe: a meta-analysis. Viruses 8(8):211Google Scholar
- 24.Hartl J, Wehmeyer MH, Pischke S (2016) Acute hepatitis E: two sides of the same coin. Viruses 8(11):299Google Scholar
- 34.Kenfak-Foguena A, Schoni-Affolter F, Burgisser P, Witteck A, Darling KE, Kovari H, Kaiser L, Evison JM, Elzi L, Gurter-De La Fuente V, Jost J, Moradpour D, Abravanel F, Izpopet J, Cavassini M (2011) Hepatitis E virus seroprevalence and chronic infections in patients with HIV, Switzerland. Emerg Infect Dis 17:1074–1078CrossRefPubMedPubMedCentralGoogle Scholar
- 38.Lee G-H, Tan B-H, Teo EC-Y, Lim S-G, Dan Y-Y, Wee A, Aw PPK, Zhu Y, Hibberd ML, Tan C-K, Purdy MA, Teo C-G (2015) Chronic infection with Camelid hepatitis E virus in a liver transplant recipient who regularly consumes camel meat and milk. Gastroenterology 170(2):355–357.e3. doi: 10.1053/j.gastro.2015.10.048
- 42.Neukam K, Barreiro P, Macias J, Avellon A, Cifuentes C, Martin-Carbonero L, Echevarria JM, Vargas J, Soriano V, Pineda JA (2013) Chronic hepatitis E in HIV patients: rapid progression to cirrhosis and response to oral ribavirin. Clin Infect Dis Off Publ Infect Dis Soc Am 57:465–468CrossRefGoogle Scholar
- 46.Passos-Castilho AM, de Sena A, Geraldo A, Spada C, Granato CFH (2015) High prevalence of hepatitis E virus antibodies among blood donors in Southern Brazil. J Med Virol. doi: 10.1002/jmv.24336
- 47.Passos-Castilho AM, Reinaldo MR, de Sena A, Granato CFH (2017) High prevalence of hepatitis E virus antibodies in Sao Paulo, Southeastern Brazil: analysis of a group of blood donors representative of the general population. Braz J Infect Dis. doi: 10.1016/j.bjid.2017.05.004
- 48.Pischke S, Suneetha PV, Baechlein C, Barg-Hock H, Heim A, Kamar N, Schlue J, Strassburg CP, Lehner F, Raupach R, Bremer B, Magerstedt P, Cornberg M, Seehusen F, Baumgaertner W, Klempnauer J, Izopet J, Manns MP, Grummer B, Wedemeyer H (2010) Hepatitis E virus infection as a cause of graft hepatitis in liver transplant recipients. Liver Transplant 16:74–82CrossRefGoogle Scholar
- 50.Ramezani A, Velayati AA, Khorami-Sarvestani S, Eslamifar A, Mohraz M, Banifazl M, Bidari-Zerehpoosh F, Yaghmaei F, McFarland W, Foroughi M, Keyvani H, Mostafavi E, Aghakhani A (2013) Hepatitis E virus infection in patients infected with human immunodeficiency virus in an endemic area in Iran. Int J STD AIDS 24:769–774CrossRefPubMedGoogle Scholar
- 55.Singh GJ, Rockwood N, Atkins M, Gazzard B, Ijaz S, Tedder R, Nelson M (2011) Chronic hepatitis E in HIV as a cause for cryptogenic cirrhosis. HIV Med 12:44Google Scholar
- 56.Smith DB, Simmonds P, International Committee on Taxonomy of Viruses Hepeviridae Study Group, Jameel S, Emerson SU, Harrison TJ, Meng XJ, Okamoto H, Van der Poel WH, Purdy MA (2014) Consensus proposals for classification of the family Hepeviridae. J Gen Virol 95:2223–2232CrossRefPubMedPubMedCentralGoogle Scholar