Seroprevalence of hepatitis E virus in patients with chronic liver disease

Lílian Rose Maia Gomes de Araújo1,2, Andrea Dória Batista2, Maria Rosângela Cunha Duarte Côelho3, Joelma Carvalho Santos4, Gabriel Galindo Cunha3, Gabriela Rodrigues Aguiar Leal1,3, João Renato Rebello Pinho5, Ana Lúcia Coutinho Domingues1,2, Edmundo Pessoa Lopes1,2,6
1Postgraduate Program in Tropical Medicine, Center of Medical Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
2Gastroenterology Division, Hospital das Clínicas – Universidade Federal de Pernambuco (UFPE), Recife, Brazil
3Laboratory of Virology, Keizo Asami Institute (LIKA), Departament of Phisiology and Pharmacology, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
4Laboratory of Immunohematology, Hemocentro de Alagoas (Hemoal), Maceió, Brazil
5Laboratory of Gastroenterology and Tropical Hepatology, Institute of Tropical Medicine and Department of Gastroenterology, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
6Department of Internal Medicine, Center of Medical Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Brazil

Tóm tắt

The seroprevalence of hepatitis E virus (HEV) in patients with chronic liver disease (CLD) is little known in Brazil. Studies have suggested that HEV may harmfully influence the course of CLD, with a higher risk of progression to cirrhosis. To estimate the prevalence of the anti-HEV antibody (IgG) in patients with CLD and to describe demographic data and risk factors, as well as clinical-laboratory and ultrasound parameters. Cross-sectional study that included 227 patients with CLD followed at a referral outpatient clinic from June 2022 to March 2023. The patients were investigated clinically and tested for liver functions, anti-HEV IgG and, in positive cases, for HEV-RNA. Ultrasonography of the upper abdomen was also carried out. Investigation of 227 patients (50 with hepatitis B, 49 with nonalcoholic fatty liver disease, 33 with hepatitis C, 17 with alcoholic liver disease, 16 with schistosomiasis and 62 with mixed disease), 55.5% were female, with an average age of 57 ± 13 years; 37.9% had liver cirrhosis. Seven patients (3.08%) presented anti-HEV positive and HEV-RNA negative. Ultrasound identified association between anti-HEV and contact with pigs, presence of gynecomastia or palmar erythema, lower platelet count, higher APRI and FIB-4 values, and splenomegaly. Although the prevalence of anti-HEV in patients with CLD was low in this study, the antibody was observed more frequently in cases with a history of contact with pigs and with clinical-laboratory or imaging evidence of more advanced chronic liver disease.

Tài liệu tham khảo

Wang B, Meng XJ (2021) Hepatitis E virus: host tropism and zoonotic infection. Curr Opin Microbiol 59:8–15. https://doi.org/10.1016/j.mib.2020.07.004 Abravanel F, Lhomme S, Costa El et al (2017) Rabbit hepatitis E virus infections in humans, France. Emerg Infect Dis 23(7):1191–1193. https://doi.org/10.3201/eid2307.170318 Kamar N, Bendall R, Legrand-Abravanel F et al (2012) Hepatitis E. Lancet 379(9835):2477–2488. https://doi.org/10.1016/S0140-6736(11)61849-7 Kamar N, Dalton HR, Abravanel F, Izopet J (2014) Hepatitis E virus infection. Clin Microbiol Rev 27(1):116–138. https://doi.org/10.1128/CMR.00057-13 Moraes DFDSD, Mesquita JR, Dutra V, Nascimento MSJ (2021) Systematic review of hepatitis E virus in Brazil: a one-health approach of the human-animal-environment triad. Animals (Basel) 11(8):2290. https://doi.org/10.3390/ani11082290 Debing Y, Moradpour D, Neyts J, Gouttenoire J (2016) Update on hepatitis E virology: implications for clinical practice. J Hepatol 65(1):200–212. https://doi.org/10.1016/j.jhep.2016.02.045 World Health Organization. Global Hepatitis Report 2017 (2017) https://www.who.int/publications/i/item/9789241565455. Accessed 02 June 2023 Li P, Liu J, Li Y et al (2020) The global epidemiology of hepatitis E virus infection: a systematic review and meta-analysis. Liver Int 40(7):1516–1528. https://doi.org/10.1111/liv.14468 Tengan MF, Figueiredo GM, Nunes AKS et al (2019) Seroprevalence of hepatitis E in adults in Brazil: a systematic review and meta-analysis. Infect Dis Poverty 8(1):3. https://doi.org/10.1186/s40249-018-0514-4 Buescher G, Ozga AK, Lorenz E (2021) Hepatitis E seroprevalence and viremia rate in immunocompromised patients: a systematic review and meta-analysis. Liver Int 41(3):449–455. https://doi.org/10.1111/liv.14695 Ma-Z M-RA, Kamar N, Pan Q (2022) Chronic hepatitis E: advancing research, and patient care. J Hepatol 77(4):1109–1123. https://doi.org/10.1016/j.jhep.2022.05.006 Wong RJ, Cheung R, Gish RG, Chitnis AS (2021) Prevalence of hepatitis E infection among adults with concurrent chronic liver disease. J Viral Hepat 28(11):1643–1655. https://doi.org/10.1111/jvh.13597 Paternostro R, Traussnigg S, Staufer K et al (2021) Prevalence of anti-hepatitis E antibodies, and the impact on disease severity in non-alcoholic fatty liver disease. Hepatol Res 51(1):69–79. https://doi.org/10.1111/hepr.13581 OPAS. Organização Pan-americana da Saúde (1997) Métodos de investigação epidemiológica em doenças transmissíveis, v.1. https://files.cercomp.ufg.br/weby/up/59/o/MetodosdeInvestigacaoEpidemiologica-SegundaEd.pdf. Accessed 03 De ago 2023 Cunha GG, Bezerra LA, Silva-Junior JVJ et al (2022) Analysis of seroprevalence and risk factors for hepatitis E virus (HEV) in the donation candidates and blood donors in Northeast Brazil. Braz J Microbiol 53(4):1995–2001. https://doi.org/10.1007/s42770-022-00816-z Silva SM, Oliveira JM, Vitral CL et al (2012) Prevalence of hepatitis E virus antibodies in individuals exposed to swine in the state of Mato Grosso, Brazil. Mem Inst Oswaldo Cruz 107(3):338–341. https://doi.org/10.1590/s0074-02762012000300007 Passos-Castilho AM, Reinaldo MR, Sena A, Granato CFH (2017) High prevalence of hepatitis E virus antibodies in São Paulo, Southeastern Brazil: analysis of a group of blood donors representative of the general population. Braz J Infect Dis 21(5):535–539. https://doi.org/10.1016/j.bjid.2017.05.004 Pandolfi R, Ramos de Almeida D, Alves Pinto M, Kreutz LC, Frandoloso R (2017) In-house ELISA based on recombinant ORF2 protein underline high prevalence of IgG anti-hepatitis E virus amongst blood donors in the south Brazil. PLoS ONE 12(5):e0176409. https://doi.org/10.1371/journal.pone.0176409 Passos-Castilho AM, de Sena A, Geraldo A, Spada C, Granato CF (2016) High prevalence of hepatitis E virus antibodies among blood donors in Southern Brazil. J Med Virol 88(2):361–364. https://doi.org/10.1002/jmv.24336 Bezerra LA, de Oliveira-Filho EF, Júnior SJVJ et al (2019) Risk analysis and seroprevalence of HEV in people living with HIV/AIDS in Brazil. Acta Trop 189:65–68. https://doi.org/10.1016/j.actatropica.2018.09.026 Moss da Silva C, Oliveira JM, Mendoza-Sassi RA et al (2019) Detection and characterization of hepatitis E virus genotype 3 in HIV-infected patients and blood donors from southern Brazil. Int J Infect Dis 86:114–121. https://doi.org/10.1016/j.ijid.2019.06.027 Ferreira AC, Gomes-Gouvêa MS, Lisboa-Neto G et al (2018) Serological and molecular markers of hepatitis E virus infection in HIV-infected patients in Brazil. Arch Virol 163(1):43–49. https://doi.org/10.1007/s00705-017-3562-3 De Oliveira JMNS, Freitas NR, Teles AS et al (2018) Prevalence of hepatitis E virus RNA and antibodies in a cohort of kidney transplant recipients in Central Brazil. Int J Infect Dis 69:41–43. https://doi.org/10.1016/j.ijid.2018.01.032 Passos AM, Heringer TP, Medina-Pestana JO et al (2013) First report and molecular characterization of hepatitis E virus infection in renal transplant recipients in Brazil. J Med Virol 85(4):615–619. https://doi.org/10.1002/jmv.23494 Hering T, Passos AM, Perez RM et al (2014) Past and current hepatitis E virus infection in renal transplant patients. J Med Virol 86(6):948–953. https://doi.org/10.1002/jmv.23915 Gomes-Gouvêa MS, Ferreira AC, Feitoza B et al (2013) Evidence of hepatitis E virus infection in liver transplant recipients from Brazil. Hepatology 58:1052A Kamar N, Garrouste C, Haagsma EB et al (2011) Factors associated with chronic hepatitis in patients with hepatitis E virus infection who have received solid-organ transplants. Gastroenterology 140(5):1481–1489. https://doi.org/10.1053/j.gastro.2011.02.050 Menezes GBL, Almeida D, Rugiere S et al (2023) Prevalence of hepatitis E Virus in patients with chronic hepatopathy in reference to the center of Bahia State, Brazil. Med Res Arch [online] 11(5). https://doi.org/10.18103/mra.v11i5.3773 Oliveira-Filho EF, Lopes KGS, Cunha DS et al (2017) Risk analysis and the occurrence of hepatitis E virus (HEV) in domestic swine in Northeast Brazil. Food Environ Virol 9(3):256–259. https://doi.org/10.1007/s12560-017-9292-6 Passos-Castilho AM, de Sena A, Domingues AL et al (2016) Hepatitis E virus seroprevalence among schistosomiasis patients in Northeastern Brazil. Braz J Infect Dis 20(3):262–266. https://doi.org/10.1016/j.bjid.2016.03.001 Bricks G, Senise J, Pott- H Jr et al (2019) Previous hepatitis E virus infection, cirrhosis and insulin resistance in patients with chronic hepatitis C. Braz J Infect Dis 23(1):45–52. https://doi.org/10.1016/j.bjid.2019.02.002