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.
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