1
|
Alexandrova R, Tsachev I, Kirov P, Abudalleh A, Hristov H, Zhivkova T, Dyakova L, Baymakova M. Hepatitis E Virus (HEV) Infection Among Immunocompromised Individuals: A Brief Narrative Review. Infect Drug Resist 2024; 17:1021-1040. [PMID: 38505248 PMCID: PMC10948336 DOI: 10.2147/idr.s449221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/21/2024] [Indexed: 03/21/2024] Open
Abstract
Hepatitis E virus (HEV) is a single-stranded positive-sense RNA virus that belongs to Hepeviridae family. HEV is the most common cause of acute viral hepatitis worldwide. According to the World Health Organization (WHO), there are estimated 20 million HEV infections worldwide every year, leading to estimated 3.3 million symptomatic cases of HEV infection. The WHO estimates that HEV infection caused approximately 44,000 deaths in 2015, which represents 3.3% of mortality rates due to viral hepatitis. In low-income (LI) countries and lower-middle-income (LMI) countries, HEV is a waterborne infection induced by HEV genotype (gt) 1 and HEV gt 2 that cause large outbreaks and affect young individuals with a high mortality rate in pregnant women from South Asian countries and patients with liver diseases. HEV gt 3, HEV gt 4, and HEV gt 7 are responsible for sporadic infections with zoonotic transmission mainly through the consumption of raw or undercooked meat from different animals. Acute HEV infection is relatively asymptomatic or mild clinical form, in rare cases the disease can be moderate/severe clinical forms and result in fulminant hepatitis or acute liver failure (ALF). Furthermore, HEV infection is associated with extrahepatic manifestations, including renal and neurological clinical signs and symptoms. Pregnant women, infants, older people, immunocompromised individuals, patients with comorbidities, and workers who come into close contact with HEV-infected animals are recognized as major risk groups for severe clinical form of HEV infection and fatal outcome. Chronic HEV infection can occur in immunocompromised individuals with the possibility of progression to cirrhosis.
Collapse
Affiliation(s)
- Radostina Alexandrova
- Department of Pathology, Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Ilia Tsachev
- Department of Microbiology, Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, Trakia University, Stara Zagora, Bulgaria
| | - Plamen Kirov
- Department of Pathology, Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Abedulkadir Abudalleh
- Department of Pathology, Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Hristo Hristov
- Department of Pathology, Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Tanya Zhivkova
- Department of Pathology, Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Lora Dyakova
- Department of Synaptic Signaling and Communication, Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Magdalena Baymakova
- Department of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria
| |
Collapse
|
2
|
du Plessis NM, Haeri Mazanderani A, Motaze NV, Ngobese M, Avenant T. Hepatitis A virus seroprevalence among children and adolescents in a high-burden HIV setting in urban South Africa. Sci Rep 2022; 12:20688. [PMID: 36450802 PMCID: PMC9712520 DOI: 10.1038/s41598-022-25064-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/24/2022] [Indexed: 12/03/2022] Open
Abstract
Hepatitis A virus (HAV) infection is one of the most important global causes of viral hepatitis. Recent reviews suggested that HAV endemicity in South Africa could shift from high to intermediate. A hospital-based HAV seroprevalence study was conducted between February 2018 and December 2019 in Pretoria, South Africa. Systematic sampling was performed on children and adolescents (1-15 years) who attended outpatient services. Participants with a known HIV status and valid HAV serology results were included. Of the 1220 participants, the median age was 7 years (IQR: 4-11), with 648 (53.11%) males and 572 (46.89%) females. Of 628 (51.48%) HIV-infected participants, most (329, 71.83%) were both immunologically and virologically controlled or had low-level viremia (74, 16.16%). Almost three-quarters (894, 73.28%) were living in formal dwellings, and just over half (688, 56.39%) had access to clean water sources inside the house. Increasing age was associated with testing HAV IgG-positive (OR 1.25; 95% CI 1.20-1.30, p < 0.001), with 19.8% of participants one year of age compared with 86.7% of participants 15 years of age. This study suggests that South Africa has an intermediate HAV seroprevalence, with rates < 90% by 10 years of age (68.6%). Increased age and informal dwellings are statistically associated with HAV seropositivity, while HIV status does not significantly influence HAV seropositivity.
Collapse
Affiliation(s)
- Nicolette M. du Plessis
- grid.49697.350000 0001 2107 2298Department of Paediatrics, Faculty of Health Sciences, Kalafong Hospital, University of Pretoria, Private Bag X396, Pretoria, 0001 South Africa ,Kalafong Provincial Tertiary Hospital, Pretoria, South Africa
| | - Ahmad Haeri Mazanderani
- grid.11951.3d0000 0004 1937 1135Department of Paediatrics & Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa ,grid.416657.70000 0004 0630 4574Centre for HIV & STIs, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Nkengafac Villyen Motaze
- grid.25881.360000 0000 9769 2525Medicine Usage in South Africa, School of Pharmacy, Faculty of Health Sciences, North West University, Potchefstroom, South Africa
| | - Makhosazane Ngobese
- grid.49697.350000 0001 2107 2298Department of Paediatrics, Faculty of Health Sciences, Kalafong Hospital, University of Pretoria, Private Bag X396, Pretoria, 0001 South Africa ,Thembisa Provincial Tertiary Hospital, Pretoria, South Africa
| | - Theunis Avenant
- grid.49697.350000 0001 2107 2298Department of Paediatrics, Faculty of Health Sciences, Kalafong Hospital, University of Pretoria, Private Bag X396, Pretoria, 0001 South Africa ,Kalafong Provincial Tertiary Hospital, Pretoria, South Africa
| |
Collapse
|
3
|
Di Lello FA, Blejer J, Alter A, Bartoli S, Vargas F, Ruiz R, Galli C, Blanco S, Carrizo LH, Gallego S, Fernández R, Martínez AP, Flichman DM. Seroprevalence of hepatitis E virus in Argentinean blood donors. Eur J Gastroenterol Hepatol 2021; 33:1322-1326. [PMID: 32675777 DOI: 10.1097/meg.0000000000001853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Hepatitis E virus (HEV) is the main cause of enteric acute viral hepatitis worldwide. In this epidemiological framework, it has become a threat to blood safety and a relevant issue for blood transfusions. However, there is a paucity of data regarding prevalence of HEV infection. The aim of this study was to determine HEV seroprevalence in blood donors from different regions from Argentina. MATERIAL AND METHODS Serum samples from 391 individuals attending five blood donor centers located in different regions from Argentina were analyzed for anti-HEV IgG and anti-HEV IgM. RESULTS Overall, anti-HEV IgG was detected in 44 out of 391 (11.3%) samples. HEV prevalence ranged from 5.1 to 20.0% among different country regions. A significant difference in blood donors' age was observed between anti-HEV IgG positive and negative individuals [44 (37-51) vs. 35 (27-43), P < 0.001, respectively]. Anti-HEV IgM was detected in 8 out of 44 (18.2%) anti-HEV IgG positive cases. CONCLUSION Anti-HEV IgG was detected in blood donor samples from five analyzed Argentinean regions, highlighting the wide distribution of the virus in the country. HEV prevalence was variable among different regions and significantly higher in older donors. Given the evidence of anti-HEV IgM presence in blood donors, suggesting a potential risk of transfusion-transmitted HEV, screening for HEV in blood units to be used in vulnerable population would be desirable. Molecular studies for detection of viremic donors and donor-recipients follow-up are necessary to certainly determine the risk of transfusion-transmitted HEV in Argentina.
Collapse
Affiliation(s)
- Federico A Di Lello
- Departamento de microbiología, inmunología, biotecnología y genética, Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Buenos Aires
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires
| | | | - Adriana Alter
- Fundación Hemocentro, Ciudad Autónoma de Buenos Aires
| | - Sonia Bartoli
- Centro regional de Hemoterapia Jujuy, San Salvador de Jujuy, Jujuy
| | - Fabiana Vargas
- Centro Regional de Hemoterapia de Mendoza, Mendoza, Mendoza
| | - Rosángela Ruiz
- Hospital Regional Rio Grande, Rio Grande, Tierra del Fuego
| | - Claudio Galli
- Hospital Regional Rio Grande, Rio Grande, Tierra del Fuego
| | - Sebastián Blanco
- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba
- Fundación Banco Central de Sangre, Córdoba, Córdoba
| | | | - Sandra Gallego
- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba
- Fundación Banco Central de Sangre, Córdoba, Córdoba
| | | | - Alfredo P Martínez
- Sección Virología, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno 'CEMIC'
| | - Diego M Flichman
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires
- Instituto de Investigaciones Biomédicas en Retrovirus y Síndrome de Inmunodeficiencia Adquirida (INBIRS) - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| |
Collapse
|
4
|
Pataccini G, Berini CA, Pedrozo WR, Biglione MM, Delfino CM. First molecular epidemiological study of hepatitis B and D in individuals infected with human T-lymphotropic virus 1/2 from Argentina. J Med Virol 2021; 93:3995-3998. [PMID: 32725912 DOI: 10.1002/jmv.26366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 07/27/2020] [Indexed: 11/08/2022]
Abstract
Human T-lymphotropic virus 1/2 (HTLV-1/2), hepatitis B virus (HBV), and hepatitis D virus (HDV) share transmission routes. Argentina shows low prevalence of HTLV-1/2, HBV, and HDV infections; however, this situation may vary according to the geographic region and group studied. The aim of this study was to estimate the prevalence of HBV and HDV infections and detect both viral genotypes in HTLV-1/2 individuals from Argentina. A total of 202 HTLV-1/2 confirmed samples (blood donors [BD] and individuals with risk factors for HTLV-1/2 [RF]) were tested for HBsAg and total anti-HBc by enzyme-linked immunosorbent assay. All reactive samples for some HBV markers were analyzed for HBV DNA characterization and HDV serological and molecular analysis. Total prevalence was 1.5% for HBsAg and 6.4% for anti-HBc. Prevalence was 23.1% for anti-HDV in all HBV-reactive samples. No significant difference was observed for HBV and HDV prevalence within HTLV subtypes. The population study showed that prevalence of anti-HBc was higher in the RF than in the BD population, with no significant differences between them. The HBsAg marker and anti-HDV were only found in RF, showing significant differences when compared to BD. Regarding molecular detection, one sample amplified for HBV DNA and none for HDV RNA. HBV sequence was classified as subgenotype F1b. New and updated background on serological markers of HBV and HDV infection in patients with HTLV-1/2 was provided.
Collapse
Affiliation(s)
- Gabriela Pataccini
- Laboratorio de Carcinogénesis Hormonal (LdeCH), Instituto de Biología y Medicina Experimental (IByME), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Carolina Andrea Berini
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Williams René Pedrozo
- Banco de Sangre Tejidos y Biológicos (BSTB) de la provincia de Misiones, Posadas, Misiones, Argentina
| | - Mirna Marcela Biglione
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Cecilia María Delfino
- Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPAM), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
| |
Collapse
|
5
|
do Nascimento RS, Baia KLN, de Souza SB, Fontoura GMG, Nunes PF, Machado LFA, Kupek E, Fischer B, Martins LC, Oliveira-Filho AB. Hepatitis E Virus in People Who Use Crack-Cocaine: A Cross-Sectional Study in a Remote Region of Northern Brazil. Viruses 2021; 13:926. [PMID: 34067873 PMCID: PMC8156048 DOI: 10.3390/v13050926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/07/2021] [Accepted: 05/09/2021] [Indexed: 12/19/2022] Open
Abstract
People who use crack-cocaine (PWUCC) have numerous vulnerabilities and pose a challenge to health and social assistance services. The exposure to pathogens and risk situations occur differently according to each individual, region and social group. This study identified the presence, genotypes and factors associated with hepatitis E virus (HEV) exposure among a community-recruited cohort of 437 PWUCC in northern Brazil. Epidemiological information was collected through community-based assessments and interviews. Thereafter, blood and fecal samples were collected and tested for HEV using an immunoenzymatic assay, and the genotype was identified by PCR. Logistic regressions were used to identify the risk factors independently associated with exposure to HEV. In total, 79 (18.1%) PWUCC were exposed to HEV: 73 (16.7%) for IgG and six for IgG + IgM. HEV RNA was detected in six fecal samples and in two blood samples from PWUCC with IgM + IgG. Subtype 3c was identified in all of the samples. The factors associated with exposure to HEV were low monthly income, unstable housing (e.g., homelessness), crack-cocaine use ≥40 months, and the shared use of crack-cocaine equipment. The current study provides unique initial insights into HEV status and risk factors among PWUCC in a remote area in Brazil, with diverse implications for urgently improved diagnosis, prevention, and treatment intervention needs.
Collapse
Affiliation(s)
- Raquel Silva do Nascimento
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil; (R.S.d.N.); (K.L.N.B.); (S.B.d.S.); (G.M.G.F.)
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, Brazil
| | - Karen Lorena N. Baia
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil; (R.S.d.N.); (K.L.N.B.); (S.B.d.S.); (G.M.G.F.)
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66055-240, Brazil; (P.F.N.); (L.C.M.)
| | - Samara Borges de Souza
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil; (R.S.d.N.); (K.L.N.B.); (S.B.d.S.); (G.M.G.F.)
- Programa de Pós-Graduação em Linguagens e Saberes na Amazônia, Bragança 68600-000, Brazil
| | - Guilherme Martins G. Fontoura
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil; (R.S.d.N.); (K.L.N.B.); (S.B.d.S.); (G.M.G.F.)
| | - Patrícia Ferreira Nunes
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66055-240, Brazil; (P.F.N.); (L.C.M.)
| | - Luiz Fernando A. Machado
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil;
| | - Emil Kupek
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis 88040-900, Brazil;
| | - Benedikt Fischer
- Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand;
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC V6B 5K3, Canada
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo 04038-000, Brazil
| | - Luísa Caricio Martins
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66055-240, Brazil; (P.F.N.); (L.C.M.)
| | - Aldemir B. Oliveira-Filho
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil; (R.S.d.N.); (K.L.N.B.); (S.B.d.S.); (G.M.G.F.)
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, Brazil
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66055-240, Brazil; (P.F.N.); (L.C.M.)
- Programa de Pós-Graduação em Linguagens e Saberes na Amazônia, Bragança 68600-000, Brazil
| |
Collapse
|
6
|
Remondegui C, Ceballos S, Arce LP, Pintado E, Vidaurre R, Nitschko H, Osterman A, Vizoso Pinto MG. Serologic evidence of the circulation of the hepatitis E virus and the prevalence of antibodies against hepatitis A in an indigenous population in northern Argentina. Rev Argent Microbiol 2021; 53:314-324. [PMID: 33648797 DOI: 10.1016/j.ram.2020.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/31/2020] [Accepted: 10/02/2020] [Indexed: 11/29/2022] Open
Abstract
In 2005 a universal vaccination program against hepatitis A was introduced in Argentina. Nevertheless, there are still some unvaccinated marginal population groups. There are no data about the seroprevalence of hepatitis E in the northern region of Argentina mainly because of lack of awareness of this emergent pathogen. We aimed to determine the seroprevalence of hepatitis A, and hepatitis E in an indigenous population in northern Argentina. One hundred and twenty six (126) donor serum samples collected near San Salvador de Jujuy were analyzed for anti-HAV IgG and HEV IgG and IgM, alkaline phosphatase and transaminase values. Volunteers were interviewed about their living conditions, animal farming, consumption of tap water or river water, and level of education. Seroprevalence of specific anti-HAV antibodies was high (80.2%, 95% confidence interval, 72.1-86.7%) in children under 5 years of age, indicating early infection in life. Seroprevalence of anti-HEV antibodies was 5.6% (95% CI: 2.3-11.2%), being slightly higher than the values found in healthy patients from other regions of the country. Although we could not characterize the genotype of the circulating HEV strain, the clear epidemiological difference between seroprevalence of HAV and HEV in a community with poor sanitary conditions suggest that the circulating HEV strains spread through a different transmission route than HAV. Furthermore a significant correlation between anti-HEV IgG and swine farming was found (p<0.05), which supports a zoonotic transmission path. We reassessed the epidemiological pattern of HAV infection and reported evidence of HEV infection for the first-time in a community belonging to the Guarani ethnic group, highlighting the need to include hepatitis E testing in routine diagnostics in the region.
Collapse
Affiliation(s)
| | | | - Lorena Paola Arce
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, San Miguel de Tucumán, Argentina; Laboratorio de Ciencias Básicas, OR. Genética, Facultad de Medicina, INSIBIO (CONICET-UNT), Universidad Nacional de Tucumán, Argentina
| | | | - Rene Vidaurre
- Hospital Paterson de San Pedro de Jujuy, Jujuy, Argentina
| | - Hans Nitschko
- Max von Pettenkofer Institute, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Munich, Germany; German Center for Infection Research (DZIF), Partner Site Munich, Germany
| | - Andreas Osterman
- Max von Pettenkofer Institute, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Munich, Germany; German Center for Infection Research (DZIF), Partner Site Munich, Germany
| | - María Guadalupe Vizoso Pinto
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, San Miguel de Tucumán, Argentina; Laboratorio de Ciencias Básicas, OR. Genética, Facultad de Medicina, INSIBIO (CONICET-UNT), Universidad Nacional de Tucumán, Argentina.
| |
Collapse
|
7
|
Maitha GM, Kikuvi G, Wanzala P, Kirui F. Influence of hepatitis B virus co-infection on virological and immunological response to antiretroviral treatment among HIV patients attending comprehensive care clinics in Makueni County, Kenya. Pan Afr Med J 2021; 38:103. [PMID: 33889269 PMCID: PMC8035691 DOI: 10.11604/pamj.2021.38.103.25793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/23/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction the effect of hepatitis B virus (HBV) infection on the natural history of human immunodeficiency virus (HIV) disease remains uncertain. Therefore, this study was conducted to determine the association of HBV co-infections with CD4 count and viral load levels in response to antiretroviral treatment among HIV patients attending comprehensive care clinics in Makueni County (Kenya). Methods this was a prospective case-control study among patients seeking HIV services in three hospitals of Makueni County (Kenya). Newly diagnosed HIV mono-infected patients (controls) and HIV/HBV co-infected (cases), 18 years and above who had not started antiretrovirals (ARVs) participated. A total of 258 patients gave informed consent and participated. HIV mono-infected (controls) produced 129 while HIV/HBV (cases) gave 129 participants. P-values ≤ 0.05 were considered significant. Results the majority (164, 63%) of the study participants were females for both arms of the study. The mean age of the participants was 31±0.402 years and majority of them were between the age of 26-30years old. At the beginning and end of the study the mean viral load for HIV/HBV co-infected individuals was (30169 and 1731) copies/ml while that of CD4 count was (327 and 459) cells/ul, and that of HIV mono-infected was (21860 and 1689) copies/ml and CD4 count of (421 and 437) cells/ul respectively. After enrolling them into antiretroviral therapy (ART) treatment and after six months of follow-up there was significant drop in viral load and significant increase in CD4 count for both groups at p<0.001 using logistic regression. Conclusion HIV patients co-infected with hepatitis B virus had high viral load and low CD4 count compared to HIV monoinfected patients however with introduction of ARVs there was improvement in both groups with the highest noticed among the HIV/HBV co-infected patients.
Collapse
Affiliation(s)
- Geoffrey Mutisya Maitha
- School of Public Health, Jomo Kenyatta University of Science Agriculture and Technology, Nairobi, Kenya
| | - Gideon Kikuvi
- School of Public Health, Jomo Kenyatta University of Science Agriculture and Technology, Nairobi, Kenya
| | | | | |
Collapse
|
8
|
Shahriarirad R, Erfani A, Rastegarian M, Zeighami A, Arefkhah N, Ghorbani F, Sarvari J, Sarkari B. Seroprevalence of anti-hepatitis E antibodies and antigens among HIV-infected patients in Fars Province, southern Iran. Virol J 2020; 17:109. [PMID: 32680534 PMCID: PMC7368745 DOI: 10.1186/s12985-020-01384-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/08/2020] [Indexed: 01/10/2023] Open
Abstract
Objective HIV-infected patients have immunological and clinical features that might affect the pathogenesis, as well as the outcome of the HIV/HEV co-infection. The current study aimed to determine the seroprevalence of anti-HEV antibodies and HEV antigens among HIV-infected patients in Fars Province, Southwest Iran. Methods Blood samples (5 mL) were collected from 251 HIV-confirmed patients. Respective data, including patients’ demographic information, were obtained for each patient. The presence of HEV antigens and anti-HEV antibodies (IgG) were assessed by commercial ELISA kits, based on the manufacturers’ instructions. Results Out of 251 cases, 158 (62.9%) were male and 91 (36.3%) were female. Patients’ age varied from 14 to 83 (mean: 40 ± 9.7) years. Out of 251 HIV positive cases, 26 (10.4%) were positive for anti-HEV IgG antibodies and 6 (2.4%) were positive for HEV-antigens. Also, 2 (0.8%) of the patients were positive for both anti-HEV IgG antibodies and antigens. Statistical analysis revealed no significant association between sex and seropositivity to either HEV antigen or antibodies. Moreover, no significant association was seen between age and seropositivity to HEV antigen or antibody (P = 0.622 and 0.945, respectively). Conclusion Our results showed a relatively low prevalence of HEV-antibodies in HIV-infected patients, indicating that HIV positive patients may not be at greater risk of HEV infection than the general population. Moreover, HEV-antigen was detected in a few cases of HIV-infected individuals which indicate an acute or chronic HEV infection in these patients.
Collapse
Affiliation(s)
- Reza Shahriarirad
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirhossein Erfani
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Rastegarian
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Zeighami
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasir Arefkhah
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fariba Ghorbani
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jamal Sarvari
- Department of Microbiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. .,Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Bahador Sarkari
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. .,Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
9
|
Risk of Hepatitis E among Persons Who Inject Drugs in Hong Kong: A Qualitative and Quantitative Serological Analysis. Microorganisms 2020; 8:microorganisms8050675. [PMID: 32384808 PMCID: PMC7284329 DOI: 10.3390/microorganisms8050675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 11/21/2022] Open
Abstract
Hepatitis E virus (HEV) is an important cause of hepatitis, which can be transmitted via the bloodborne route. However, risk of hepatitis E among persons who inject drugs (PWIDs) is poorly understood. This study aimed to elucidate whether PWIDs are at risk for hepatitis E. We performed HEV IgM, IgG and nucleic acid detection on a cohort of 91 PWIDs and 91 age- and sex-matched organ donors. Blood HEV IgG was measured using the WHO HEV antibody standard. The effects of age, gender and addictive injection use on HEV serostatus and concentration were assessed. HEV IgG seroprevalence was 42/91 (46.2%) in the PWID group and 20/91 (22%) in the donor group (odds ratio = 3.04 (1.59–5.79), p = 0.0006). The median HEV IgG concentration was 5.8 U/mL (IQR: 2.5–7.9) in the PWID group and 2.1 U/mL (IQR: 1.2–5.3) in the donor group (p = 0.005). Increasing age and addictive injection use were significantly associated with HEV IgG serostatus, but only addictive injection use was associated with HEV IgG concentration (p = 0.024). We conclude that PWIDs are at increased risk for hepatitis E and are prone to repeated HEV exposure and reinfection as indicated by higher HEV IgG concentrations.
Collapse
|
10
|
Weitzel T, Rodríguez F, Noriega LM, Marcotti A, Duran L, Palavecino C, Porte L, Aguilera X, Wolff M, Cortes CP. Hepatitis B and C virus infection among HIV patients within the public and private healthcare systems in Chile: A cross-sectional serosurvey. PLoS One 2020; 15:e0227776. [PMID: 31917810 PMCID: PMC6952094 DOI: 10.1371/journal.pone.0227776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 12/27/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coinfections of HIV patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) are mayor public health problems, contributing to the emerging burden of HIV-associated hepatic mortality. Coinfection rates vary geographically, depending on various factors such as predominant transmission modes, HBV vaccination rates, and prevalence of HBV and HCV in the general population. In South America, the epidemiology of coinfections is uncertain, since systematic studies are scarce. Our study aimed to analyze rates of HBV and HCV infection in people living with HIV attending centers of the public and private health system in Chile. METHODS We performed a cross-sectional study including a public university hospital and a private health center in Santiago, Metropolitan Region in Chile. Serum samples were used to determine serological markers of hepatitis B (HBsAg, anti-HBs, anti-HBc total, HBeAg, anti-HBe) and anti-HCV. Demographic, clinical and laboratory data were obtained from medical records. RESULTS 399 patients were included (353 from public, 46 from private health center). Most (92.8%) were male, with a median age of 38.3 years; 99.4% acquired HIV through sexual contact (75.0% MSM); 25.7% had AIDS and 90.4% were on ART. In 78.9%, viral loads were <40 cps/mL; the median CD4 cell count was 468 cells/mm3. According to their serological status, 37.6% of patients were HBV naïve (susceptible), 6.5% were vaccinated, 43.6% had resolved HBV infection, and 5.8% were chronically infected. The rate of vaccination was 4.5% in the public and 21.7% in the private system. HCV coinfection was found in 1.0% of all patients. CONCLUSION HBV coinfection rate was within the range of other South American countries, but lower than in non-industrialized regions in Asia and Africa. A low percentage of patients were HBV vaccinated, especially within the public system. HCV coinfection rate was very low, most probably due to the rareness of injecting drug use.
Collapse
Affiliation(s)
- Thomas Weitzel
- Laboratorio Clínico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | | | - Luis Miguel Noriega
- Departamento de Medicina Interna, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Alejandra Marcotti
- Departamento de Medicina Interna, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Luisa Duran
- Departamento de Medicina Interna, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Carla Palavecino
- Departamento de Medicina, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Lorena Porte
- Laboratorio Clínico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Ximena Aguilera
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Marcelo Wolff
- Fundación Arriarán, Santiago, Chile
- Departamento de Medicina, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Claudia P. Cortes
- Fundación Arriarán, Santiago, Chile
- Departamento de Medicina, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| |
Collapse
|
11
|
Human Immunodeficiency Virus Infected Patients are Not at Higher Risk for Hepatitis E Virus Infection: A Systematic Review and Meta-Analysis. Microorganisms 2019; 7:microorganisms7120618. [PMID: 31779204 PMCID: PMC6955890 DOI: 10.3390/microorganisms7120618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/18/2019] [Accepted: 11/21/2019] [Indexed: 12/15/2022] Open
Abstract
Hepatitis E virus (HEV) infection is the most common cause of acute hepatitis in the world. It is not well established whether people infected with the human immunodeficiency virus (HIV) are more susceptible to infection with HEV than people not infected with HIV. Many studies have evaluated this relationship, although none are conclusive. The aim of this systematic review and meta-analysis was to assess whether patients with HIV infection constitute a risk group for HEV infection. A systematic review and meta-analysis was performed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), to find publications comparing HEV seroprevalences among HIV infected and uninfected populations. The analysis was matched by sex, age and geographical area, and compared patients who live with HIV and HIV-negative individuals. The odds ratio (OR) for patients with HIV was 0.87 (95% CI: 0.74-1.03) in the fixed effects meta-analysis and 0.88 (95% CI: 0.70-1.11) in random effects, with I2 = 47%. This study did not show that HIV infection was a risk factor for HEV infection when compared with those who are HIV-negative.
Collapse
|
12
|
Detection and characterization of hepatitis E virus genotype 3 in HIV-infected patients and blood donors from southern Brazil. Int J Infect Dis 2019; 86:114-121. [PMID: 31279609 DOI: 10.1016/j.ijid.2019.06.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 06/21/2019] [Accepted: 06/30/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Hepatitis E virus genotype 3 (HEV-3) infection usually causes self-limited acute hepatitis. In immunosuppressed patients, HEV-3 infection can rapidly progress to chronic hepatitis and cirrhosis. In southern Brazil, data on HEV seroprevalence are scarce. METHODS Testing for HEV RNA and antibodies (anti-HEV) was performed for 320 HIV-infected patients followed at the HIV/AIDS Service of the Federal University of Rio Grande between 2012 and 2013, as well as 281 blood donor samples obtained in 2015. Variables associated with anti-HEV positivity were assessed by multivariable logistic regression analysis. RESULTS HIV and blood donor groups showed similar HEV seroprevalence (6.7% and 7.1%, respectively). Risk factors associated with anti-HEV detection were older age, marital status, a higher number of sexual partners, poor sanitation, and alcohol use (HIV group), and living in a rural area (blood donors). HEV RNA was detected in eight serum samples from HIV-infected patients and in one blood donor, who was also positive for anti-HEV IgM and IgG. CONCLUSIONS The prevalence rates of HEV infection were comparable between HIV-seropositive patients who were not severely immunocompromised and blood donors. The blood donor's HEV isolate showed high similarity with swine HEV strains from Brazilian herds in the same region, thus indicating a potential risk of foodborne and parenteral transmission via blood transfusion.
Collapse
|
13
|
Rivero-Juarez A, Lopez-Lopez P, Frias M, Rivero A. Hepatitis E Infection in HIV-Infected Patients. Front Microbiol 2019; 10:1425. [PMID: 31297100 PMCID: PMC6608679 DOI: 10.3389/fmicb.2019.01425] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 06/05/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The hepatitis E virus (HEV) represents a major cause of acute hepatitis worldwide. The majority of HEV cases occur in low-income countries, mainly Asia and Africa, where HEV causes large outbreaks associated with the consumption of contaminated water and high mortality in specific populations. In high-income countries, HEV infection is considered a zoonotic disease that is linked to the consumption of contaminated food. Although a high proportion of cases have self-limiting asymptomatic or subclinical infections, immunosuppression may modify the pathogenesis and clinical impact of this emerging disease. RESULTS AND DISCUSSION Here, we review the current knowledge about the epidemiology, diagnosis, clinical manifestations, management and prevention of HEV infection in HIV-infected subjects. CONCLUSIONS Despite the increasing knowledge about the pathogenesis, epidemiology and clinical impact of HEV infection, several major factors are faced by HIV-infected patients, including treatment recommendations, immunization and risk practices.
Collapse
Affiliation(s)
- Antonio Rivero-Juarez
- Infectious Diseases Unit, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía de Córdoba, Universidad de Córdoba, Córdoba, Spain
| | | | | | | |
Collapse
|
14
|
Scarponi CFDO, Silva RDND, Souza Filho JAD, Guerra MRL, Pedrosa MAF, Mol MPG. Hepatitis Delta Prevalence in South America: A Systematic Review and Meta-Analysis. Rev Soc Bras Med Trop 2019; 52:e20180289. [PMID: 30698197 DOI: 10.1590/0037-8682-0289-2018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 12/18/2018] [Indexed: 02/06/2023] Open
Abstract
Hepatitis delta virus (HDV) has been associated with acute or chronic hepatitis in Latin America, but there is no prevalence study covering South American countries. This meta-analysis aimed to estimate anti-HDV prevalence through a systematic review of published articles in English, Portuguese and Spanish until December 2017. Searches were conducted in Health Virtual Library, Capes, Lilacs, PubMed, and SciELO, according to defined criteria regarding participant selection and geographical setting. Study quality was assessed using the GRADE guidelines. Pooled anti-HDV prevalence was calculated using the DerSimonian-Laird random-effects model with Freeman-Tukey double arcsine transformation. Out of the 405 identified articles, only 31 met the eligibility criteria for inclusion in the meta-analysis. In South America, pooled anti-HDV prevalence among hepatitis B virus carriers was 22.37% (95% confidence interval: 13.72-32.26), though it appeared less frequently in some countries and populations, according to the data collection date. The findings indicated significant successive reductions in anti-HDV prevalence over thirty years. However, there was a scarcity of HDV epidemiological studies outside the Amazon Basin, notably in the Southwest continent and absence of target population standardization. There was a high HDV prevalence in South American countries, despite differences in methodological characteristics and outcomes, highlighting a drastic decline in the last decades. Future studies should identify HDV prevalence estimates in other regions of the continent and identify risk factors.
Collapse
Affiliation(s)
| | | | | | | | | | - Marcos Paulo Gomes Mol
- Diretoria de Pesquisa e Desenvolvimento. Fundação Ezequiel Dias, Belo Horizonte, MG, Brasil
| |
Collapse
|
15
|
Horvatits T, Ozga AK, Westhölter D, Hartl J, Manthey CF, Lütgehetmann M, Rauch G, Kriston L, Lohse AW, Bendall R, Wedemeyer H, Dalton HR, Pischke S. Hepatitis E seroprevalence in the Americas: A systematic review and meta-analysis. Liver Int 2018; 38:1951-1964. [PMID: 29660259 DOI: 10.1111/liv.13859] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 04/05/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS While hepatitis E virus infections are a relevant topic in Europe, knowledge about epidemiology of hepatitis E virus infections in the USA and Latin America is still limited. Aim of this study was to estimate anti-hepatitis E virus IgG seroprevalence in the Americas and to assess whether low socioeconomic status is associated with hepatitis E virus exposure. METHODS We performed a systematic review and meta-analysis. Literature search was performed in PubMed for articles published 01/1994-12/2016. Prevalence was estimated using a mixed-effects model and reported in line with PRISMA reporting guidelines. RESULTS Seroprevalence was significantly higher in the USA than in Latin America, independently of assay, patient cohort, methodological quality or study year (OR: 1.82 (1.06-3.08), P = .03). Patients in the USA had a more than doubled estimated seroprevalence (up to 9%, confidence interval 5%-15.6%) than those in Brazil (up to 4.2%, confidence interval 2.4%-7.1%; OR: 2.27 (1.25-4.13); P = .007) and Mixed Caribbean (up to 1%, OR: 8.33 (1.15-81.61); P = .04). A comparison with published data from Europe demonstrated that anti-hepatitis E virus seroprevalence in the USA and Europe did not differ significantly (OR: 1.33 (0.81-2.19), P = .25), while rate in South America was significantly lower than that in Europe (OR: 0.67 (0.45-0.98), P = .04). CONCLUSIONS Hepatitis E virus is common in the USA. Surprisingly, the risk of hepatitis E virus exposure was low in many South American countries. Seroprevalence did not differ significantly between Europe and the USA. Hence, hepatitis E virus is not limited to countries with low sanitary standards, and a higher socioeconomic status does not protect populations from hepatitis E virus exposure.
Collapse
Affiliation(s)
- Thomas Horvatits
- Department of Medicine I, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ann-Kathrin Ozga
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dirk Westhölter
- Department of Medicine I, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johannes Hartl
- Department of Medicine I, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carolin F Manthey
- Department of Medicine I, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marc Lütgehetmann
- Institute of Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, Hamburg, Germany
| | - Geraldine Rauch
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
| | - Levente Kriston
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ansgar W Lohse
- Department of Medicine I, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, Hamburg, Germany
| | - Richard Bendall
- Royal Cornwall Hospital Trust and European Centre for Environment and Human Health, University of Exeter, Truro, UK
| | - Heiner Wedemeyer
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, Hamburg, Germany.,Department of Gastroenterology, Hepatology, University Hospital of Essen, Essen, Germany
| | - Harry R Dalton
- Royal Cornwall Hospital Trust and European Centre for Environment and Human Health, University of Exeter, Truro, UK
| | - Sven Pischke
- Department of Medicine I, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, Hamburg, Germany
| |
Collapse
|
16
|
Pisano MB, Martinez-Wassaf MG, Mirazo S, Fantilli A, Arbiza J, Debes JD, Ré VE. Hepatitis E virus in South America: The current scenario. Liver Int 2018; 38:1536-1546. [PMID: 29788538 DOI: 10.1111/liv.13881] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/04/2018] [Indexed: 12/11/2022]
Abstract
Hepatitis E virus (HEV) is one of the most frequent causes of acute viral hepatitis of enteric transmission worldwide. In South America the overall epidemiology has been little studied, and the burden of the disease remains largely unknown. A research of all scientific articles about HEV circulation in South America until November 2017 was carried out. Human seroprevalences of HEV varied according to the studied population: blood donors presented prevalence rates ranging from 1.8% to 9.8%, while reports from HIV-infected individuals, transplant recipients and patients on hemodialysis showed higher prevalence rates. Only 2 cases of chronic hepatitis in solid-organ transplant patients from Argentina and Brazil have been described. Detection of HEV in the swine population is widely prevalent in the region. Anti-HEV antibodies have also been recently documented in wild boars from Uruguay. Although scarce, studies focused on environmental and food HEV detection have shown viral presence in these kind of samples, highlighting possible transmission sources of HEV in the continent. HEV genotype 3 was the most frequently detected in the region, with HEV genotype 1 detected only in Venezuela and Uruguay. HEV is widely distributed throughout South America, producing sporadic cases of acute hepatitis, but as a possible agent of chronic hepatitis. Finding the virus in humans, animals, environmental samples and food, show that it can be transmitted through many sources, alerting local governments and health systems to improve diagnosis and for the implementation of preventive measures.
Collapse
Affiliation(s)
- María B Pisano
- Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | | | - Santiago Mirazo
- Sección Virología, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - Anabella Fantilli
- Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Juan Arbiza
- Sección Virología, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - José D Debes
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Viviana E Ré
- Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| |
Collapse
|
17
|
Salvio AL, Lopes AO, Almeida AJ, Gardinali NR, Lima LRP, de Oliveira JM, Sion FS, Ribeiro LCP, Pinto MA, de Paula VS. Detection and quantification of hepatitis E virus in the absence of IgG and IgM anti-HEV in HIV-positive patients. J Appl Microbiol 2018; 125:1208-1215. [PMID: 29920871 DOI: 10.1111/jam.14024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/28/2018] [Accepted: 06/08/2018] [Indexed: 12/20/2022]
Abstract
AIMS To improve RT-qPCR with an internal control and a synthetic standard curve to detect HEV in HIV co-infected patients. METHODS AND RESULTS A single-stranded RNA (ssRNA) and a double-stranded DNA (dsDNA) synthetic curve were designed, compared to the international reference panel for HEV genotypes, and tested to quantify and detect a reference panel for HEV genotypes. The detection limit of the RNA synthetic curve (50 copies per ml) was better than the DNA synthetic curve (100 copies per ml) and the WHO standard curve (250 copies per ml). Then, 280 serum samples from HIV-positive patients were tested for HEV RNA, which was detected in 3·6% of serum samples. The viral load ranged from 2 × 102 copies per ml to 4·78 × 108 copies per ml. HEV IgM/IgG antibodies were not detected in the RNA-positive patients. Sequencing analysis of HEV showed that the virus belongs to genotype 3 (HEV GT3). CONCLUSIONS Real-time PCR was a useful tool to estimate co-infection with HEV/HIV, even in patients with low viral loads and undetectable anti-HEV IgG and IgM antibodies. SIGNIFICANCE AND IMPACT OF THE STUDY Hepatitis E virus genotype 3 (HEV GT3) has been associated with silent chronic hepatitis and cirrhosis in HIV-positive subjects worldwide, but there is a lack of data on this co-infection in Brazil.
Collapse
Affiliation(s)
- A L Salvio
- Laboratory of Molecular Virology, Oswaldo Cruz Institute/Fiocruz, Rio de Janeiro, Brazil
| | - A O Lopes
- Laboratory of Molecular Virology, Oswaldo Cruz Institute/Fiocruz, Rio de Janeiro, Brazil
| | - A J Almeida
- Hematology Department, Gaffrée & Guinle Universitary Hospital, Rio de Janeiro State Federal University/UniRio, Rio de Janeiro, Brazil
| | - N R Gardinali
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute/Fiocruz, Rio de Janeiro, Brazil
| | - L R P Lima
- Laboratory of Molecular Virology, Oswaldo Cruz Institute/Fiocruz, Rio de Janeiro, Brazil
| | - J M de Oliveira
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute/Fiocruz, Rio de Janeiro, Brazil
| | - F S Sion
- Hematology Department, Gaffrée & Guinle Universitary Hospital, Rio de Janeiro State Federal University/UniRio, Rio de Janeiro, Brazil
| | - L C P Ribeiro
- Hematology Department, Gaffrée & Guinle Universitary Hospital, Rio de Janeiro State Federal University/UniRio, Rio de Janeiro, Brazil
| | - M A Pinto
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute/Fiocruz, Rio de Janeiro, Brazil
| | - V S de Paula
- Laboratory of Molecular Virology, Oswaldo Cruz Institute/Fiocruz, Rio de Janeiro, Brazil
| |
Collapse
|
18
|
Shrestha A, Adhikari A, Bhattarai M, Rauniyar R, Debes JD, Boonstra A, Lama TK, Al Mahtab M, Butt AS, Akbar SMF, Aryal N, Karn S, Manandhar KD, Gupta BP. Prevalence and risk of hepatitis E virus infection in the HIV population of Nepal. Virol J 2017; 14:228. [PMID: 29162143 PMCID: PMC5696774 DOI: 10.1186/s12985-017-0899-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/15/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Infection with the hepatitis E virus (HEV) can cause acute hepatitis in endemic areas in immune-competent hosts, as well as chronic infection in immune-compromised subjects in non-endemic areas. Most studies assessing HEV infection in HIV-infected populations have been performed in developed countries that are usually affected by HEV genotype 3. The objective of this study is to measure the prevalence and risk of acquiring HEV among HIV-infected individuals in Nepal. METHODS We prospectively evaluated 459 Human Immunodeficiency Virus (HIV)-positive individuals from Nepal, an endemic country for HEV, for seroprevalence of HEV and assessed risk factors associated with HEV infection. All individuals were on antiretroviral therapy and healthy blood donors were used as controls. RESULTS We found a high prevalence of HEV IgG (39.4%) and HEV IgM (15.3%) in HIV-positive subjects when compared to healthy HIV-negative controls: 9.5% and 4.4%, respectively (OR: 6.17, 95% CI 4.42-8.61, p < 0.001 and OR: 3.7, 95% CI 2.35-5.92, p < 0.001, respectively). Individuals residing in the Kathmandu area showed a significantly higher HEV IgG seroprevalance compared to individuals residing outside of Kathmandu (76.8% vs 11.1%, OR: 30.33, 95% CI 18.02-51.04, p = 0.001). Mean CD4 counts, HIV viral load and presence of hepatitis B surface antigen correlated with higher HEV IgM rate, while presence of hepatitis C antibody correlated with higher rate of HEV IgG in serum. Overall, individuals with HEV IgM positivity had higher levels of alanine aminotransferase (ALT) than IgM negative subjects, suggesting active acute infection. However, no specific symptoms for hepatitis were identified. CONCLUSIONS HIV-positive subjects living in Kathmandu are at higher risk of acquiring HEV infection as compared to the general population and to HIV-positive subjects living outside Kathmandu.
Collapse
Affiliation(s)
| | - Anurag Adhikari
- Kathmandu Research Institute for Biological Sciences, Lalitpur, Nepal
| | - Manjula Bhattarai
- Kathmandu Research Institute for Biological Sciences, Lalitpur, Nepal
| | - Ramanuj Rauniyar
- Kathmandu Research Institute for Biological Sciences, Lalitpur, Nepal
| | - Jose D Debes
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - André Boonstra
- Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, the Netherlands
| | | | - Mamun Al Mahtab
- Department of Hepatology, BangabandhuShiekhMujib Medical University, Dhaka, Bangladesh
| | - Amna Subhan Butt
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | | | - Nirmal Aryal
- Virology Unit, Central Department of Biotechnology, Tribhuvan University, Kathmandu, Nepal
| | - Sapana Karn
- St. Xavier's College Maitighar, Kathmandu, Nepal
| | - Krishna Das Manandhar
- Virology Unit, Central Department of Biotechnology, Tribhuvan University, Kathmandu, Nepal
| | - Birendra Prasad Gupta
- Virology Unit, Central Department of Biotechnology, Tribhuvan University, Kathmandu, Nepal.
| |
Collapse
|
19
|
Lee YL, Lin KY, Cheng CY, Li CW, Yang CJ, Tsai MS, Tang HJ, Lin TY, Wang NC, Lee YC, Lin SP, Huang YS, Sun HY, Zhang JY, Ko WC, Cheng SH, Lee YT, Liu CE, Hung CC. Evolution of hepatitis A virus seroprevalence among HIV-positive adults in Taiwan. PLoS One 2017; 12:e0186338. [PMID: 29036227 PMCID: PMC5643057 DOI: 10.1371/journal.pone.0186338] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 10/01/2017] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The study aimed to describe the seroprevalence of hepatitis A virus (HAV) in HIV-positive adult patients in Taiwan between 2012 and 2016 and to examine the evolution of HAV seroprevalence between 2004-2007 and 2012-2016. METHODS Clinical information and data of anti-HAV antibody results were collected from 2,860 antiretroviral-naïve HIV-positive Taiwanese aged 18 years or older who initiated combination antiretroviral therapy at 11 hospitals around Taiwan between 2012 and 2016 (2012-2016 cohort). A multivariate logistic regression model was applied to identify independent variables associated with HAV seropositivity. Comparisons of HAV seroprevalences and associated clinical characteristics were made between this 2012-2016 cohort and a previous cohort of 1580 HIV-positive patients in 2004-2007 (2004-2007 cohort). RESULTS Of the 2,860 HIV-positive patients between 2012 and 2016, the overall HAV seropositivity rate was 21.2% (605/2860), which was independently associated with an older age (adjusted odds ratio [AOR], per 1-year increase, 1.13; 95% confidence interval [95% CI], 1.11-1.15) and co-infection with hepatitis B virus (AOR 1.44; 95% CI, 1.08-1.93). Residence in southern Taiwan (AOR 0.49; 95% CI, 0.34-0.72) was inversely associated with HAV seropositivity. The overall HAV seroprevalence in the 2012-2016 cohort was significantly lower than that in the 2004-2007 cohort (21.2% vs 60.9%, p<0.01). The decreases of HAV seropositivity rate were observed in nearly every age-matched group, which suggested the cohort effect on HAV seroepidemiology. However, among individuals aged 25 years or younger, the HAV seropositivity rate increased from 3.8% (2/52) in the 2004-2007 cohort to 8.5% (50/587) in the 2012-2016 cohort, with 95.4% (560/587) being MSM in this age group of the latter cohort. CONCLUSIONS HAV seroprevalence has decreased with time among HIV-positive adults in Taiwan. The cohort effect has increased the number of young HIV-positive patients that are susceptible to HAV infection in a country without nationwide childhood vaccination program against HAV.
Collapse
Affiliation(s)
- Yu-Lin Lee
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Kuan-Yin Lin
- Department of Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan
| | - Chien-Yu Cheng
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
- School of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Wen Li
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Department of Medicine, National Cheng Kung University Medical College, Tainan, Taiwan
| | - Chia-Jui Yang
- Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Mao-Song Tsai
- Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Hung-Jen Tang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
- Department of Health and Nutrition, Chia Nan University of Pharmacy and Sciences, Tainan, Taiwan
| | - Te-Yu Lin
- Department of Internal Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Ning-Chi Wang
- Department of Internal Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Yi-Chien Lee
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Shih-Ping Lin
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Shan Huang
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Hsin-Yun Sun
- Department of Internal Medicine, National Taiwan University Hospital, and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jun-Yu Zhang
- Center of Infection Control, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Chien Ko
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Department of Medicine, National Cheng Kung University Medical College, Tainan, Taiwan
| | - Shu-Hsing Cheng
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
- School of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yuan-Ti Lee
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- * E-mail: (CEL); (YTL)
| | - Chun-Eng Liu
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
- * E-mail: (CEL); (YTL)
| | - Chien-Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital, and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan
| | | |
Collapse
|
20
|
Serological and molecular markers of hepatitis E virus infection in HIV-infected patients in Brazil. Arch Virol 2017; 163:43-49. [PMID: 28965214 DOI: 10.1007/s00705-017-3562-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 09/01/2017] [Indexed: 12/19/2022]
Abstract
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.
Collapse
|
21
|
Tengan FM, Abdala E, Nascimento M, Bernardo WM, Barone AA. Prevalence of hepatitis B in people living with HIV/AIDS in Latin America and the Caribbean: a systematic review and meta-analysis. BMC Infect Dis 2017; 17:587. [PMID: 28836955 PMCID: PMC5571507 DOI: 10.1186/s12879-017-2695-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 08/20/2017] [Indexed: 12/17/2022] Open
Abstract
Background Hepatitis B virus (HBV) infection is a major cause of chronic liver disease worldwide. In immunocompromised patients, the chronicity rates of HBV infection are higher, but the rates of hepatitis Be antigen (HBeAg) and HBsAg loss and seroconversion to anti-HBe and anti-HBs are lower than those in immunocompetent subjects. This study aimed to evaluate articles on the prevalence of HBsAg in people living with human immunodeficiency virus (HIV) /AIDS (PLWHA) in Latin America and the Caribbean (LAC). Methods We searched the PubMed, Latin American and Caribbean Health Sciences, and Embase databases for studies up to November 2016 on infection with HIV and HBV in LAC without period or language restrictions. We did not include case reports, case series, review articles, comments, or studies with a sample size smaller than 100. We also evaluated the quality of the articles using a list of criteria totaling 21 items. Results Of the 28 selected articles (n = 18,457) published from 1999 to 2016, 18 studies (64.3%) were from Brazil, 3 (10.7%) were from Argentina, 2 (7.1%) were from Chile, 2 (7.1%) were from Cuba, 1 (3.6%) was from Colombia, 1 (3.6%) was from Venezuela, and 1 (3.6%) was from Jamaica. The mean score for the assessment of the study quality was 11.6 (range: 8–16). The estimated pooled prevalence of HBsAg among PLWHA in the selected studies was 7.0% (95% CI 7.0–7.0%). The pooled prevalence of HBsAg was 8.0% (95% CI 8.0–9.0%) in the studies published from 1999 to 2006 and 6.0% (95% CI 5.0–6.0%) in the studies published during the later timeframe. Conclusions The results of this review indicate the need to increase the investment in preventive measures against hepatitis B, particularly when the impact of adequate vaccination in this population is considered. Future studies with larger sample sizes are needed in LAC to determine the true prevalence of hepatitis B throughout the region and to clarify and address the risk factors associated with the acquisition of infection. Electronic supplementary material The online version of this article (10.1186/s12879-017-2695-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Fatima Mitiko Tengan
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil. .,Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil.
| | - Edson Abdala
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil.,Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil
| | - Marisa Nascimento
- Nursing Division, Clinics Hospital, School of Medicine, USP, São Paulo, SP, Brazil
| | | | - Antonio Alci Barone
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil.,Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil
| |
Collapse
|
22
|
Jordan AE, Perlman DC, Neurer J, Smith DJ, Des Jarlais DC, Hagan H. Prevalence of hepatitis C virus infection among HIV+ men who have sex with men: a systematic review and meta-analysis. Int J STD AIDS 2017; 28:145-159. [PMID: 26826159 PMCID: PMC4965334 DOI: 10.1177/0956462416630910] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Since 2000, an increase in hepatitis C virus infection among HIV-infected (HIV+) men who have sex with men has been observed. Evidence points to blood exposure during sex as the medium of hepatitis C virus transmission. Hepatitis C virus prevalence among HIV + MSM overall and in relation to injection drug use is poorly characterized. In this study, a systematic review and meta-analysis examining global hepatitis C virus antibody prevalence and estimating active hepatitis C virus prevalence among HIV + MSM were conducted; 42 reports provided anti-hepatitis C virus prevalence data among HIV + MSM. Pooled prevalence produced an overall anti-hepatitis C virus prevalence among HIV + MSM of 8.1%; active HCV prevalence estimate was 5.3%-7.3%. Anti-hepatitis C virus prevalence among injection drug use and non-injection drug use HIV + MSM was 40.0% and 6.7%, respectively. Among HIV + MSM, hepatitis C virus prevalence increased significantly over time among the overall and non-injection drug use groups, and decreased significantly among injection drug use HIV + MSM. We identified a moderate prevalence of hepatitis C virus among all HIV + MSM and among non-injection drug use HIV + MSM; for both, prevalence was observed to be increasing slightly. Pooled prevalence of hepatitis C virus among HIV + MSM was higher than that observed in the 1945-1965 US birth cohort. The modest but rising hepatitis C virus prevalence among HIV + MSM suggests an opportunity to control HCV among HIV + MSM; this combined with data demonstrating a rising hepatitis C virus incidence highlights the temporal urgency to do so.
Collapse
Affiliation(s)
- Ashly E Jordan
- 1 New York University, New York, NY, USA
- 2 Center for Drug Use and HIV Research, New York, NY, USA
| | - David C Perlman
- 2 Center for Drug Use and HIV Research, New York, NY, USA
- 3 Icahn School of Medicine, Mount Sinai Beth Israel, New York, NY, USA
| | | | | | - Don C Des Jarlais
- 2 Center for Drug Use and HIV Research, New York, NY, USA
- 3 Icahn School of Medicine, Mount Sinai Beth Israel, New York, NY, USA
| | - Holly Hagan
- 1 New York University, New York, NY, USA
- 2 Center for Drug Use and HIV Research, New York, NY, USA
| |
Collapse
|
23
|
Pisano MB, Balderramo D, Wassaf MM, Lotto M, Carlino Y, Ré VE, Debes JD. Hepatitis E virus infection in patients on dialysis and in solid organ transplant recipients in Argentina: exploring associated risk factors. Arch Virol 2016; 162:787-792. [DOI: 10.1007/s00705-016-3171-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 10/27/2016] [Indexed: 12/21/2022]
|
24
|
Tengan FM, Ibrahim KY, Dantas BP, Manchiero C, Magri MC, Bernardo WM. Seroprevalence of hepatitis C virus among people living with HIV/AIDS in Latin America and the Caribbean: a systematic review. BMC Infect Dis 2016; 16:663. [PMID: 27829381 PMCID: PMC5103446 DOI: 10.1186/s12879-016-1988-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 10/29/2016] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Studies have shown that the immunosuppression induced by the human immunodeficiency virus (HIV) accelerates the natural history of liver disease associated with hepatitis C virus (HCV), with 3- to 5-fold higher odds of coinfected individuals developing cirrhosis. However, estimates of the seroprevalence of hepatitis C among people living with HIV/acquired immune deficiency syndrome (AIDS) (PLHA) in Latin America and the Caribbean (LAC) are widely variable. METHODS We performed a systematic review to estimate the seroprevalence of HCV among PLHA. We searched studies on HIV and HCV infections in LAC included in the PubMed, LILACS and Embase databases in December of 2014 with no time or language restrictions. The following combinations of search terms were used in the PubMed and Embase databases: (HIV OR Acquired Immunodeficiency Syndrome Virus OR AIDS OR HTLV OR Human Immunodeficiency Virus OR Human T Cell) AND (HCV OR HEPATITIS C OR HEPATITIS C VIRUS OR HEPACIVIRUS) AND (name of an individual country or territory in LAC). The following search terms were used in the LILACS database: (HIV OR AIDS OR Virus da Imunodeficiencia Humana) AND (HCV OR Hepatite C OR Hepacivirus). An additional 11 studies were identified through manual searches. A total of 2,380 publications were located, including 617 duplicates; the remaining articles were reviewed to select studies for inclusion in this study. RESULTS A total of 37 studies were selected for systematic review, including 23 from Brazil, 5 from Argentina, 3 from Cuba, 1 from Puerto Rico, 1 from Chile, 1 from Colombia, 1 from Mexico, 1 from Peru and 1 from Venezuela. The estimated seroprevalence of HCV infection varied from 0.8 to 58.5 % (mean 17.37; median 10.91), with the highest in Argentina and Brazil and the lowest in Venezuela and Colombia. CONCLUSIONS Investigation of HCV infection among PLHA and of HIV infection among people living with HCV is highly recommended because it allows for better follow up, counseling and treatment of HIV/HCV-coinfected patients. Future studies with larger sample sizes are needed in both South and Central America to understand and address the risk factors associated with the acquisition of infection.
Collapse
Affiliation(s)
- Fatima Mitiko Tengan
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil. .,Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil.
| | - Karim Yakub Ibrahim
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil.,Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil
| | - Bianca Peixoto Dantas
- Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil
| | - Caroline Manchiero
- Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil
| | - Mariana Cavalheiro Magri
- Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil
| | | |
Collapse
|
25
|
Debes JD, Pisano MB, Lotto M, Re V. Hepatitis E virus infection in the HIV-positive patient. J Clin Virol 2016; 80:102-6. [PMID: 27243210 DOI: 10.1016/j.jcv.2016.05.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 05/16/2016] [Indexed: 12/12/2022]
Abstract
Hepatitis E virus (HEV) is a RNA virus that can cause hepatitis. In immunocompetent individuals, infection with HEV usually leads to asymptomatic seroconversion. However, in immunosuppressed patients, such as transplant recipients, HEV can develop into a chronic infection. Studies regarding the seroprevalence and clinical implications of HEV in patients infected with the human immunodeficiency virus (HIV) are conflicting. Levels of CD4 count in blood seem to be the most widely associated risk factor, while other factors such as meat consumption or proximity to animals are less clearly associated with HEV infection. Progression to chronicity, as well as extrahepatic manifestations of HEV seem rare in HIV, and the implications of HEV in liver disease progression are poorly understood in the HIV-infected. In this review we describe the epidemiology, risk factors, and clinical implications of HEV infection in individuals infected with HIV.
Collapse
Affiliation(s)
- Jose D Debes
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States, United States.
| | - Maria Belen Pisano
- Instituto de Virología "Dr. J. M. Vanella" Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Argentina
| | - Martin Lotto
- Instituto de Virología "Dr. J. M. Vanella" Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Argentina
| | - Viviana Re
- Instituto de Virología "Dr. J. M. Vanella" Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Argentina
| |
Collapse
|
26
|
Pischke S, Schwarze-Zander C, Bremer B, Lehmann P, Wiegand SB, Gisa A, Behrendt P, Strassburg CP, Manns MP, Wedemeyer H, Rockstroh JK. Hepatitis E Virus Seroprevalence Rate in HIV-Infected Patients in Germany: A Comparison of Two Commercial Assays. Intervirology 2015; 58:283-7. [PMID: 26625157 DOI: 10.1159/000441472] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 08/27/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Cases of chronic hepatitis E virus (HEV) infection have been described in HIV-infected patients. There are several commercial anti-HEV assays, but anti-HEV seroprevalence rates differ largely depending on the assay used. The aim of this study was to (1) compare two commercial anti-HEV assays in a German cohort of HIV-positive individuals, and (2) determine whether HEV takes chronic courses in controlled HIV infection. METHODS 246 HIV patients were tested for both HEV RNA and HEV antibodies. All patients received antiretroviral therapy, if this was indicated, according to European guidelines. All but 19 individuals had CD4+ counts above 200/µl. Anti-HEV IgG was determined by two independent commercial assays (Wantai and MP). RESULTS None of the patients tested HEV RNA positive. Anti-HEV IgG was detected more frequently by the Wantai assay (26%) than the MP assay (1.6%, p < 0.001). Patients born in Europe tested more frequently positive for anti-HEV (p = 0.047) than individuals from other regions. Increasing age but not CD4 count correlated with a higher likelihood of anti-HEV positivity (R = 0.313, p < 0.001). CONCLUSIONS About one quarter of HIV-infected patients show evidence of previous HEV contact. The risk of developing chronic HEV infection is very low in individuals receiving appropriate antiretroviral therapy. The large variability in HEV seroprevalence rates determined by different assays requires consideration for the diagnostic workup of HIV patients.
Collapse
Affiliation(s)
- Sven Pischke
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Abstract
Hepatitis B and A account for considerable morbidity and mortality worldwide. Immunization is the most effective means of preventing hepatitis B and A. However, the immune response to both hepatitis vaccines seems to be reduced in HIV-infected subjects. The aim of this review was to analyze the immunogenicity, safety, long-term protection and current recommendations of hepatitis B and A vaccination among HIV-infected adults. The factors most frequently associated with a deficient level of anti-HBs or IgG anti-HAV after vaccination are those related to immunosuppression (CD4 level and HIV RNA viral load) and to the frequency of administration and/or the amount of antigenic load per dose. The duration of the response to both HBV and HAV vaccines is associated with suppression of the viral load at vaccination and, in the case of HBV vaccination, with a higher level of antibodies after vaccination. In terms of safety, there is no evidence of more, or different, adverse effects compared with HIV-free individuals. Despite literature-based advice on the administration of alternative schedules, revaccination after the failure of primary vaccination, and the need for periodic re-evaluation of antibody levels, few firm recommendations are found in the leading guidelines.
Collapse
Affiliation(s)
- G Mena
- a Department of Preventive Medicine & Care Quality ; Hospital General Universitario de Castellón ; Castellón de la Plana , Spain
| | - A L García-Basteiro
- b ISGlobal; Barcelona Ctr. Int. Health Res. (CRESIB); Hospital Clínic - Universitat de Barcelona ; Barcelona , Spain.,c Centro de Investigação em Saúde deg Manhiça (CISM) ; Manhiça, Maputo , Mozambique
| | - J M Bayas
- b ISGlobal; Barcelona Ctr. Int. Health Res. (CRESIB); Hospital Clínic - Universitat de Barcelona ; Barcelona , Spain.,d Department of Preventive Medicine & Epidemiology ; Hospital Clínic de Barcelona; Universitat de Barcelona ; Barcelona , Spain
| |
Collapse
|
28
|
Scotto G, Grisorio B, Filippini P, Ferrara S, Massa S, Bulla F, Martini S, Filippini A, Tartaglia A, Lo Muzio L, Fazio V. Hepatitis E virus co-infection in HIV-infected patients in Foggia and Naples in southern Italy. Infect Dis (Lond) 2015; 47:707-13. [PMID: 25994453 DOI: 10.3109/23744235.2015.1049658] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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).
Collapse
Affiliation(s)
- Gaetano Scotto
- From the 1 Chair of Microbiology and Clinical Microbiology, University of Foggia , Foggia , Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Politou M, Boti S, Androutsakos T, Valsami S, Pittaras T, Kapsimali V. Seroprevalence of hepatitis E in HIV infected patients in Greece. J Med Virol 2015; 87:1517-20. [PMID: 25965115 DOI: 10.1002/jmv.24214] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2015] [Indexed: 12/23/2022]
Abstract
HEV infection is an emerging public health problem worldwide Data concerning HEV infection in HIV+ patients in Greece is scare. The aim of the study was to determine HEV seroprevalence in patients with HIV infection in Greece. We studied 243 HIV(+) patients 214 men (88%) and 29 women (12%) with a median age of 45 years (range 19-83) who attended the HIV unit of Pathophysiology Department of Laikon General Hospital in Athens for the presence of anti-HEV IgG antibodies with (EIA) (EIA HEV IgG, Adaltis, Rome, Italy Eighteen/243 patients (7.3%) were positive for HEV IgG antibodies, a seroprevalence that was not different from that described for the blood donors group from Greece There was no difference of the presence of HbsAg, hepatitis C and hepatitis A between the HEV(+) and HEV(-) patients. There was no statistically significant difference between the HEV(+) and HEV(-) group in terms of HIV acquisition, sexual orientation, median duration of HIV infection, ART treatment, or duration of ART. Only the median age of HEV(+) was 52 years (35-78) while that of HEV(-) was 44 years (19-83)(P = 0.03). Only 2/18(11.1%) HEV(+) HIV(+) patients had abnormal ALT and AST values. The seroprevalence of hepatitis E in HIV(+) patients in Greece seems to be the same with that of the general population thus implying that HIV infection is not a risk factor for HEV infection and only age shows a positive correlation with seropositivity.
Collapse
Affiliation(s)
- Marianna Politou
- Hematology Laboratory, Blood Bank, Aretaieion Hospital, Athens, Greece
| | - Sofia Boti
- AIDS Unit, Pathophysiology Clinic, Laikon Hospital, Athens, Greece
| | | | - Serena Valsami
- Hematology Laboratory, Blood Bank, Aretaieion Hospital, Athens, Greece
| | - Theodoros Pittaras
- Microbiology Laboratory, Medical School of National and Kapodistrian University of Athens, Athens, Greece
| | - Violetta Kapsimali
- Microbiology Laboratory, Medical School of National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
30
|
Ramezani A, Mohraz M, Banifazl M, Aghakhani A. Significance of hepatitis E virus infection in HIV-infected patients: a challenging issue. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2015. [DOI: 10.1016/s2222-1808(14)60794-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
31
|
Freitas SZ, Teles SA, Lorenzo PC, Puga MAM, Tanaka TSO, Thomaz DY, Martins RMB, Druzian AF, Lindenberg ASC, Torres MS, Pereira SA, Villar LM, Lampe E, Motta-Castro ARC. HIV and HCV coinfection: prevalence, associated factors and genotype characterization in the Midwest Region of Brazil. Rev Inst Med Trop Sao Paulo 2015; 56:517-24. [PMID: 25351547 PMCID: PMC4296873 DOI: 10.1590/s0036-46652014000600011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 04/29/2014] [Indexed: 12/19/2022] Open
Abstract
A cross-sectional study on prevalence, associated factors and genotype
distribution of HCV infection was conducted among 848 HIV-infected patients
recruited at reference centers in the Midwest Region of Brazil. The prevalence
rate of HIV-HCV coinfection was 6.9% (95% CI: 5.2 to 8.6).
In multivariable analysis, increasing age, use of illicit drugs (injection
and non-injection), a history of blood transfusion before 1994, and the
absence of a steady partnership were significant independent associated factors
for HIV-HCV coinfection. The phylogenetic analysis based on the NS5B region
revealed the presence of two major circulating genotypes of HCV: genotypes 1
(58.3%) and 3 (41.7%). The prevalence of HIV-HCV
coinfection was lower than those reported in studies conducted with HIV-infected
patients in different regions of Brazil, due to the fact that illicit drug use
is not a frequent mode of HIV transmission in this region of Brazil. Serologic
screening of HIV-patients for HCV before initiating antiretroviral treatment, a
comprehensive identification of associated factors, and the implementation of
effective harm reduction programs are highly recommended to provide useful
information for treatment and to prevent HCV coinfection in these patients.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Marina Sawada Torres
- Hematology and Hemotherapy Center of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | | | | | | | | |
Collapse
|
32
|
Mena G, Vilajeliu A, Urbiztondo L, Bayas JM. [Regional recommendations on hepatitis vaccination in human immunodeficiency virus infected adult patients in Spain: Evidence-based disparity?]. Med Clin (Barc) 2015; 145:163-70. [PMID: 25771339 DOI: 10.1016/j.medcli.2014.12.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 12/17/2014] [Accepted: 12/20/2014] [Indexed: 01/18/2023]
Affiliation(s)
- Guillermo Mena
- Servicio de Medicina Preventiva y Calidad Asistencial, Hospital General Universitari de Castelló, Castelló de la Plana, España
| | - Alba Vilajeliu
- Servicio de Medicina Preventiva y Epidemiología ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, España
| | - Luis Urbiztondo
- Agència de Salut Pública de Catalunya, Departament de Salut, Generalitat de Catalunya, Barcelona, España
| | - José M Bayas
- Servicio de Medicina Preventiva y Epidemiología ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, España.
| |
Collapse
|
33
|
Martínez Wassaf MG, Pisano MB, Barril PA, Elbarcha OC, Pinto MA, Mendes de Oliveira J, DiGiusto P, Nates SV, Ré VE. First detection of hepatitis E virus in Central Argentina: environmental and serological survey. J Clin Virol 2014; 61:334-9. [PMID: 25213209 DOI: 10.1016/j.jcv.2014.08.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 08/12/2014] [Accepted: 08/19/2014] [Indexed: 12/24/2022]
Abstract
BACKGROUND The hepatitis E virus (HEV) is an emergent causative agent of acute hepatitis worldwide, transmitted by fecal-oral route. In Argentina it is considered rare, so differential laboratory testing is not routinely performed. Besides, in Argentina's central area epidemiological and molecular characteristics of HEV are still unknown. OBJECTIVES Provide evidence of local circulation of HEV by molecular detection on environmental samples and by serological survey in healthy adult population of Córdoba city, Argentina. STUDY DESIGN Environmental surveillance was conducted in river and sewage samples collected between 2007 and 2009-2011. Viral detection was performed by RT-Nested PCR of ORF-1 and ORF-2 partial regions. Anti-HEV IgG was determined by EIA in 433 serum samples collected between 2009 and 2010. RESULTS HEV was detected in 6.3% of raw sewage samples and in 3.2% of riverine samples. Nucleotide sequencing analyses revealed that all isolates belonged to genotype 3, subtypes a, b and c. The prevalence of IgG anti-HEV was 4.4%. Seroprevalence increased with the age of the individuals (OR: 3.50; 95% CI 1.39-8.87; p=0.0065) and, although the prevalence was higher in low income population, no statistical relation was found between anti-HEV and socioeconomic level. CONCLUSIONS The environmental findings added to serological results, demonstrate that HEV circulates in central Argentina. Contamination of water with HEV could represent a route of transmission for local populations, which have a high number of susceptible individuals. This fact alerts local health care systems in order to include detection of HEV in the diagnostic algorithm of viral hepatitis.
Collapse
Affiliation(s)
- Maribel G Martínez Wassaf
- Department of Virology, School of Chemical Sciences, Catholic University of Córdoba, Argentina; Department of Virology and Molecular Biology, LACE Laboratories, Córdoba, Argentina.
| | - María B Pisano
- Department of Virology, School of Chemical Sciences, Catholic University of Córdoba, Argentina; Virology Institute "Dr. J.M. Vanella", School of Medical Sciences, National University of Córdoba, Argentina.
| | - Patricia A Barril
- Virology Institute "Dr. J.M. Vanella", School of Medical Sciences, National University of Córdoba, Argentina.
| | - Osvaldo C Elbarcha
- Department of Virology, School of Chemical Sciences, Catholic University of Córdoba, Argentina; Department of Virology and Molecular Biology, LACE Laboratories, Córdoba, Argentina.
| | - Marcelo A Pinto
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| | - Jaqueline Mendes de Oliveira
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| | - Pablo DiGiusto
- Virology Institute "Dr. J.M. Vanella", School of Medical Sciences, National University of Córdoba, Argentina.
| | - Silvia V Nates
- Virology Institute "Dr. J.M. Vanella", School of Medical Sciences, National University of Córdoba, Argentina.
| | - Viviana E Ré
- Department of Virology, School of Chemical Sciences, Catholic University of Córdoba, Argentina; Virology Institute "Dr. J.M. Vanella", School of Medical Sciences, National University of Córdoba, Argentina.
| |
Collapse
|
34
|
Junaid SA, Agina SE, Abubakar KA. Epidemiology and associated risk factors of hepatitis e virus infection in plateau state, Nigeria. Virology (Auckl) 2014; 5:15-26. [PMID: 25512696 PMCID: PMC4251053 DOI: 10.4137/vrt.s15422] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 04/21/2014] [Accepted: 04/22/2014] [Indexed: 12/22/2022] Open
Abstract
A cross-sectional study in Nigeria was undertaken to determine the epidemiology, seroprevalence, and associated risk factors, of hepatitis E virus (HEV). A total of 462 subjects were used for the study, categorized into four groups: apparently healthy persons, pregnant women, HIV positive subjects, and animal handlers. Information was obtained from subjects using interviewer-administered questionnaire. Blood samples were collected and analyzed for HEV antibodies (IgG and IgM) using enzyme-linked immunosorbent assay (ELISA) technique. Results obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 17.0 statistical software. The overall seroprevalence of IgG and IgM was 42.7 and 0.9%, respectively. Animal handlers had the highest seroprevalence (66.7%). The associated risk factors for IgM seroprevalence were rural dwelling (P = 0.039, odds ratio (OR) 3.3, 95% confidence interval (CI) 0.7–15.4), blood transfusion (P < 0.001, OR 9.6, 95% CI 2.6–35.6), attending to animals (P = 0.032, OR 4.9, 95% CI 0.9–26.6), and waste disposal (P < 0.001). Factors associated with IgG were age (P = 0.044), location (P < 0.001), marital status (P < 0.001), formal education (P < 0.001), farming as occupation (P < 0.001), rural dwelling (P = 0.001), waste disposal (P < 0.001), alcohol consumption (P = 0.001, OR 2.4, 95% CI 1.4–4.0), open defecation (P < 0.001, OR 2.9, 95% CI 1.4–5.7), attending to animals (P < 0.001, OR 2.3, 95% CI 1.6–3.4), consuming unwashed fruits/vegetables (P < 0.001, OR 4.2, 95% CI 0.3–54.1), and stream/river as a source of drinking water (P < 0.001, OR 3.6, 95% CI 1.6–7.8). Preventive public health measures should be reinforced among all communities, particularly domestic animal handlers and pregnant women. Potable water should be provided for all communities. Data suggest that HEV remains an under-recognized and significant public health problem, warranting further attention and research.
Collapse
Affiliation(s)
- Surajudeen A Junaid
- Applied Microbiology Unit, Department of Plant Science and Technology, Faculty of Natural Sciences, University of Jos, Nigeria. ; Department of Medical Microbiology, Federal College of Veterinary and Medical Laboratory Technology, National Veterinary Research Institute (NVRI), Vom, Nigeria
| | - Samuel E Agina
- Applied Microbiology Unit, Department of Plant Science and Technology, Faculty of Natural Sciences, University of Jos, Nigeria
| | - Khadijah A Abubakar
- Department of Medical Virology, Federal College of Veterinary and Medical Laboratory Technology, National Veterinary Research Institute (NVRI), Vom, Nigeria
| |
Collapse
|
35
|
Abstract
Hepatitis C is the leading cause of chronic hepatitis, cirrhosis, and liver cancer in Argentina, where from 1.5% to 2.5% of adults are infected. Most of the infections were acquired 30-50 years ago. It is estimated that more than half of infected individuals are not aware of their infection. Even though the prevalence in blood donors has decreased to 0.45% at present, many high-prevalence populations still exist, where the reported prevalence ranges from 2.2% to 7.1%. Therapy is recommended for patients with fibrosis, in order to prevent disease progression, hepatic decompensation, and hepatocellular carcinoma. Great advances were achieved in the treatment of genotype 1 infection since the development and release of boceprevir and telaprevir. When either of these protease inhibitors is associated with peginterferon plus ribavirin, the sustained virological response (SVR) rate improves from 40%-50% to 67%-75%. For genotype 2 and 3 infection, treatment with peginterferon plus ribavirin is still the standard of care, with SVR rates of 70%-90%. There are significant new antivirals in development, and some of them are close to being released. These drugs will most likely be the future standard of care for all genotypes, and will be incorporated in better-tolerated and highly effective all-oral regimes. The impact that these new therapies might have in health-related economics is unpredictable, especially in developing countries. Each country must carefully evaluate the local situation in order to implement proper screening and treatment programs. Difficult-to-treat patients, such as those with decompensated cirrhosis, patients in hemodialysis, and those with other significant comorbidities, might not be able to receive these new therapeutic approaches and their management will remain challenging.
Collapse
Affiliation(s)
| | - Sebastián Marciano
- Hepatology Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | | |
Collapse
|
36
|
Freitas SZ, Soares CC, Tanaka TSO, Lindenberg ASC, Teles SA, Torres MS, Mello FCA, Mendes-Corrêa MC, Savassi-Ribas F, Motta-Castro ARC. Prevalence, risk factors and genotypes of hepatitis B infection among HIV-infected patients in the State of MS, Central Brazil. Braz J Infect Dis 2014; 18:473-80. [PMID: 24662138 PMCID: PMC9428200 DOI: 10.1016/j.bjid.2014.01.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 01/16/2014] [Accepted: 01/31/2014] [Indexed: 12/13/2022] Open
Abstract
Objectives A cross-sectional study on prevalence of HBV and HDV infection, risk factors and genotype distribution of HBV infection was conducted among 848 HIV-infected patients in Mato Grosso do Sul, Central Brazil. Methods Serum samples of 848 participants were tested for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc) and hepatitis surface antibody (anti-HBs). HBsAg positive samples were tested for anti-HBc IgM, HBeAg, anti-HBe, anti-HCV, and total anti-HDV. HBsAg and anti-HBc positive were subjected to DNA extraction. Viral DNA was amplified by semi-nested PCR for the regions pre-S/S and then purified and genotyped/subgenotyped by direct sequencing. Student's t-test, chi-square test and Fisher's exact test were used to compare variables and to evaluate association between HBV positivity (defined as anti-HBc and/or HBsAg positivity) and risk factors. Results Among the 848 HIV infected patients investigated 222 had serological markers of HBV infection. The prevalence rate of HIV-HBV coinfection was 2.5% (21/848; 95% CI: 1.4–3.5%); 484 (57.1%) patients were susceptible for HBV infection. There were no cases of anti-HDV positive and only one (0.1%) anti-HCV-positive case among the HIV-HBV coinfected patients. Male gender, increasing age, family history of hepatitis, use of illicit drug, and homosexual activity were independent factors associated with HBV exposure. The phylogenetic analysis based on the S gene region revealed the presence of genotypes D (76.9%), F (15.4%) and A (7.7%) in the study sample. Conclusion This study demonstrates the low prevalence of HIV-HBV infection and also highlights the need for early vaccination against HBV as well as testing for HBV, HCV and HDV in all HIV-infected individuals.
Collapse
Affiliation(s)
| | | | | | | | | | - Marina Sawada Torres
- Hematology and Hemotherapy Center of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | | | | | | | - Ana Rita Coimbra Motta-Castro
- Universidade Federal do Mato Grosso do Sul, Campo Grande, MS, Brazil; Fundação Oswaldo Cruz, Campo Grande, MS, Brazil
| |
Collapse
|
37
|
Echevarría JM. Light and Darkness: Prevalence of Hepatitis E Virus Infection among the General Population. SCIENTIFICA 2014; 2014:481016. [PMID: 24672733 PMCID: PMC3941225 DOI: 10.1155/2014/481016] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 12/25/2013] [Indexed: 05/05/2023]
Abstract
Human hepatitis E virus (HHEV) spreads early in life among the population in areas endemic for genotype 1 and infects mainly adults in areas endemic for genotype 3, where it would be responsible for about 10% of cases of suspected acute viral hepatitis of unknown etiology and for a number of subclinical, unrecognized infections. The overall prevalence of antibody to HHEV is high in most of the former areas and low in most of the later ones, but wide regional differences have been recorded in both cases. "Hot spots" of HHEV infection would exist for both types of strains in particular regions or among particular populations of the world. Studies on pork derivatives, shellfish bivalves, and vegetables for HHEV contamination at the sale point need to be extended for evaluating the impact of the agent on food safety, and the meaning of the finding of HHEV genotype 1 genomes in urban sewage from developed countries should be established through active surveillance. Consensus about technical issues in regard to anti-HEV testing would improve the knowledge of the HHEV epidemiology. Studies in particular regions and populations, and introduction of molecular diagnosis in the clinical setting as a routine tool, would also be required.
Collapse
Affiliation(s)
- José-Manuel Echevarría
- Department of Virology, National Centre of Microbiology, Instituto de Salud Carlos III, Road Majadahonda-Pozuelo, Km2, Majadahonda, 28220 Madrid, Spain
- *José-Manuel Echevarría:
| |
Collapse
|
38
|
Krain LJ, Nelson KE, Labrique AB. Host immune status and response to hepatitis E virus infection. Clin Microbiol Rev 2014; 27:139-65. [PMID: 24396140 PMCID: PMC3910912 DOI: 10.1128/cmr.00062-13] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Hepatitis E virus (HEV), identified over 30 years ago, remains a serious threat to life, health, and productivity in developing countries where access to clean water is limited. Recognition that HEV also circulates as a zoonotic and food-borne pathogen in developed countries is more recent. Even without treatment, most cases of HEV-related acute viral hepatitis (with or without jaundice) resolve within 1 to 2 months. However, HEV sometimes leads to acute liver failure, chronic infection, or extrahepatic symptoms. The mechanisms of pathogenesis appear to be substantially immune mediated. This review covers the epidemiology of HEV infection worldwide, the humoral and cellular immune responses to HEV, and the persistence and protection of antibodies produced in response to both natural infection and vaccines. We focus on the contributions of altered immune states (associated with pregnancy, human immunodeficiency virus [HIV], and immunosuppressive agents used in cancer and transplant medicine) to the elevated risks of chronic infection (in immunosuppressed/immunocompromised patients) and acute liver failure and mortality (among pregnant women). We conclude by discussing outstanding questions about the immune response to HEV and interactions with hormones and comorbid conditions. These questions take on heightened importance now that a vaccine is available.
Collapse
Affiliation(s)
- Lisa J. Krain
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kenrad E. Nelson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alain B. Labrique
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
39
|
Riveiro-Barciela M, Buti M, Homs M, Campos-Varela I, Cantarell C, Crespo M, Castells L, Tabernero D, Quer J, Esteban R, Rodriguez-Frías F. Cirrhosis, liver transplantation and HIV infection are risk factors associated with hepatitis E virus infection. PLoS One 2014; 9:e103028. [PMID: 25068388 PMCID: PMC4113416 DOI: 10.1371/journal.pone.0103028] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 06/26/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Acute and chronic hepatitis E have been associated with high mortality and development of cirrhosis, particularly in solid-organ recipients and patients infected by human immunodeficiency virus. However, data regarding the epidemiology of hepatitis E in special populations is still limited. AIMS Investigate seroprevalence and possible factors associated with HEV infection in a large cohort of immunosuppressed patients. METHODS Cross-sectional study testing IgG anti-HEV in serum samples from 1373 consecutive individuals: 332 liver-transplant, 296 kidney-transplant, 6 dual organ recipients, 301 non-transplanted patients with chronic liver disease, 238 HIV-infected patients and 200 healthy controls. RESULTS IgG anti-HEV was detected in 3.5% controls, 3.7% kidney recipients, 7.4% liver transplant without cirrhosis and 32.1% patients who developed post-transplant cirrhosis (p<0.01). In patients with chronic liver disease, IgG anti-HEV was also statistically higher in those with liver cirrhosis (2% vs 17.5%, p<0.01). HIV-infected patients showed an IgG anti-HEV rate of 9.2%, higher than those patients without HIV infection (p<0.03). Multivariate analysis showed that the factors independently associated with anti-HEV detection were liver cirrhosis, liver transplantation and HIV infection (OR: 7.6, 3.1 and 2.4). HCV infection was a protective factor for HEV infection (OR: 0.4). CONCLUSIONS HEV seroprevalence was high in liver transplant recipients, particularly those with liver cirrhosis. The difference in anti-HEV prevalence between Liver and Kidney transplanted cases suggests an association with advanced liver disease. Further research is needed to ascertain whether cirrhosis is a predisposing factor for HEV infection or whether HEV infection may play a role in the pathogeneses of cirrhosis.
Collapse
Affiliation(s)
- Mar Riveiro-Barciela
- Liver Unit, Internal Medicine Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - María Buti
- Liver Unit, Internal Medicine Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Hospital Universitario Vall d'Hebron, Barcelona, Spain
- * E-mail:
| | - María Homs
- Liver Pathology Unit/Virology Unit Biochemistry and Microbiology Departments, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Isabel Campos-Varela
- Liver Unit, Internal Medicine Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Carmen Cantarell
- Nephrology Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Manuel Crespo
- Infectious Diseases Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Lluís Castells
- Liver Unit, Internal Medicine Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - David Tabernero
- Liver Pathology Unit/Virology Unit Biochemistry and Microbiology Departments, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Josep Quer
- Liver Unit, Internal Medicine Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Rafael Esteban
- Liver Unit, Internal Medicine Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Francisco Rodriguez-Frías
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Hospital Universitario Vall d'Hebron, Barcelona, Spain
- Liver Pathology Unit/Virology Unit Biochemistry and Microbiology Departments, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| |
Collapse
|
40
|
Arends JE, Ghisetti V, Irving W, Dalton HR, Izopet J, Hoepelman AIM, Salmon D. Hepatitis E: An emerging infection in high income countries. J Clin Virol 2013; 59:81-8. [PMID: 24388207 DOI: 10.1016/j.jcv.2013.11.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 11/11/2013] [Accepted: 11/25/2013] [Indexed: 12/26/2022]
Abstract
Hepatitis E virus (HEV) genotype 3 is the most recently characterized hepatotropic virus and is increasingly being recognized as the cause of unexplained liver disease in many western countries. Although asymptomatic in most cases, HEV GT3 may be responsible for a wide range of illnesses, from mild to fulminant acute hepatitis, and also chronic hepatitis in immunocompromised patients. Extrahepatic manifestations have been occasionally described. Anti-HEV antibody detection by immunoassays is hampered by moderate test accuracy particularly in immunocompromised hosts while a WHO international standard for molecular detection of HEV RNA by RT-PCR has recently been introduced. This review describes the basic virology, epidemiology, clinical virology and treatment of HEV GT3 infections in high income countries.
Collapse
Affiliation(s)
- J E Arends
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands; Members of the European Study Group on Viral Hepatitis (ESGVH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Switzerland.
| | - V Ghisetti
- Microbiology & Virology Laboratory, Department of Infectious Diseases, Amedeo di Savoia Hospital, Turin, Italy; Members of the European Study Group on Viral Hepatitis (ESGVH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Switzerland
| | - W Irving
- Faculty of Medicine & Health Sciences, NIHR Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham, United Kingdom; Members of the European Study Group on Viral Hepatitis (ESGVH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Switzerland
| | - H R Dalton
- Peninsula College of Medicine and Dentistry, Royal Cornwall Hospital Trust, Truro, United Kingdom
| | - J Izopet
- Centre de Physiopathologie de Toulouse-Purpan, Université Paul Sabatier, Toulouse, France
| | - A I M Hoepelman
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands; Members of the European Study Group on Viral Hepatitis (ESGVH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Switzerland
| | - D Salmon
- Department of Infectious Diseases, Hôpital Cochin, Paris, France; Members of the European Study Group on Viral Hepatitis (ESGVH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Switzerland
| |
Collapse
|
41
|
Hepatitis B virus and hepatitis D virus in blood donors from Argentina: circulation of HBsAg and reverse transcriptase mutants. Arch Virol 2013; 159:1109-17. [DOI: 10.1007/s00705-013-1917-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 10/31/2013] [Indexed: 01/04/2023]
|
42
|
Echevarría JM, González JE, Lewis-Ximenez LL, Dos Santos DRL, Munné MS, Pinto MA, Pujol FH, Rodríguez-Lay LA. Hepatitis E virus infection in Latin America: a review. J Med Virol 2013; 85:1037-45. [PMID: 23588729 DOI: 10.1002/jmv.23526] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2012] [Indexed: 12/11/2022]
Abstract
Data reported during recent years reveal the complex picture of the epidemiology of hepatitis E virus (HEV) infection in Latin America. Whereas in countries like Argentina and Brazil is almost identical to the characteristic of most countries from North America and Europe, HEV in the Caribbean and Mexico involves the water-borne, non-zoonotic viral genotypes responsible for epidemics in Asia and Africa. Nevertheless, Latin America has been considered a highly endemic region for hepatitis E in the scientific literature, a generalization that ignores the above complexity. In addition, reports from isolated Amerindian communities, which display well known, important and very specific epidemiological features for hepatitis B and D virus infections are neither taken into account when considering the epidemiology of hepatitis E in the region. This review updates compilation of the available information for the HEV infection, both among humans and other mammals, in Latin America, discusses the strengths and the weaknesses of our current knowledge, and identifies future areas of research.
Collapse
|
43
|
Muriuki BM, Gicheru MM, Wachira D, Nyamache AK, Khamadi SA. Prevalence of hepatitis B and C viral co-infections among HIV-1 infected individuals in Nairobi, Kenya. BMC Res Notes 2013; 6:363. [PMID: 24016453 PMCID: PMC3844558 DOI: 10.1186/1756-0500-6-363] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 09/03/2013] [Indexed: 12/25/2022] Open
Abstract
Background Hepatitis B virus (HBV) and Hepatitis C virus (HCV) co-infections among HIV-1 infected individuals are growing worldwide health problems characterized by lack of effective vaccines, need for expensive treatment, chronicity of morbidity and associated mortality. Their prevalence and distribution patterns continue to vary across geographical locations with high prevalence being detected among high risk populations. To determine the prevalence of HBV and HCV among HIV-1 infected individuals, blood samples were collected from consenting study subjects visiting comprehensive HIV clinics in Nairobi during the period between October and December 2009. Methods Blood samples from volunteers were screened with ELISA tests for detecting HIV, HBV surface antigen (HBsAg) and anti-HCV antibodies. Results In a total of three (300) hundred infected individuals consisting of 129 (43%) males and 171 (57%) females 15.3% (46/300) were HIV-1 co-infected with either HBV or HCV or both, 10.3% (31/300) with HIV-1 and HCV and 6% (18/300) with HIV-1 and HBV infections. However, only three individuals (1%) were coinfected with the three viruses (HIV/HBV/HCV). Conclusion Though, low levels of co-infection with all three viruses were reported, there could be higher prevalence rates than reported here especially among high risk populations.
Collapse
|
44
|
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. Hepatitis E virus infection in patients infected with human immunodeficiency virus in an endemic area in Iran. Int J STD AIDS 2013; 24:769-74. [PMID: 23970597 DOI: 10.1177/0956462413484457] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Some studies have suggested that hepatitis E virus is more frequent in human immunodeficiency virus (HIV) patients and can progress to chronic infection. We aimed to determine the prevalence of hepatitis E virus antibodies and RNA in a series of 100 HIV-infected patients in Tehran, Iran, with comparison to 52 healthy HIV, hepatitis B and C-negative blood donors as controls. HIV-infected patients were also tested for hepatitis E virus-RNA. Among the HIV-infected patients, 10% had antibodies to hepatitis E virus - a finding not significantly different from the uninfected controls (11.5%). No HIV-infected patients had hepatitis E virus IgM antibodies nor did any have detectable hepatitis E virus-RNA. We found no associations between anti-hepatitis E virus IgG-seropositivity and age, sex, route of HIV acquisition, aminotransferases levels, CD4, antiretroviral therapy, hepatitis B virus and hepatitis C virus co-infection. Hepatitis E virus is relatively prevalent in our HIV-infected patients, although without evidence of chronic infection and no more common than among HIV-negative controls or the general population. For the present, we do not recommend routine screening for hepatitis E virus infection in HIV-infected patients in our moderately endemic region.
Collapse
Affiliation(s)
- Amitis Ramezani
- Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Otto-Knapp R, Cortes CP, Saavedra F, Wolff M, Weitzel T. Hepatitis B prevalence and influence on HIV treatment outcome and mortality in the Chilean AIDS Cohort. Int J Infect Dis 2013; 17:e919-24. [PMID: 23849398 DOI: 10.1016/j.ijid.2013.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Revised: 05/13/2013] [Accepted: 05/14/2013] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES To analyze the prevalence of hepatitis B virus (HBV) co-infection and its influence on mortality and treatment outcome within a large AIDS cohort in Chile. METHODS Clinical and epidemiological data from the Chilean AIDS Cohort were retrospectively analyzed. Adult patients tested for hepatitis B surface antigen (HBsAg) during the time period of October 2001 to October 2007 were included. RESULTS Of 5115 cohort patients, 1907 met the inclusion criteria. The prevalence of HBV co-infection was 8.4%. Overall mortality rates were 2.15 and 1.77 per 100 person-years for HBsAg-positive and HBsAg-negative HIV patients, respectively, with a mortality rate ratio of 1.22 (95% confidence interval 0.58-2.54). Kaplan-Meier survival and Cox regression analysis did not show significant differences between the groups. Virological and immunological responses to antiretroviral therapy (ART) were not influenced by HBsAg status, but in co-infected patients, initial ART was more frequently changed. CONCLUSIONS The prevalence of hepatitis B co-infection was 8.4%, indicating a markedly elevated hepatitis B risk compared to the general population in Chile. Neither treatment outcome nor overall mortality was influenced by hepatitis B co-infection. Still, patients with hepatitis B co-infection had less stable ART regimens, which might be related to a higher risk of hepatotoxic drug effects.
Collapse
Affiliation(s)
- Ralf Otto-Knapp
- Lungenklinik Heckeshorn, Clinic for Respiratory and Infectious Diseases, HELIOS Klinikum Emil von Behring, Berlin, Germany
| | | | | | | | | |
Collapse
|
46
|
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-Hübinger AM. Hepatitis E virus infections in HIV-infected patients in Ghana and Cameroon. J Clin Virol 2013; 58:18-23. [PMID: 23743346 DOI: 10.1016/j.jcv.2013.05.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 04/30/2013] [Accepted: 05/05/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND Chronic hepatitis E virus (HEV) infections have recently been described in HIV-infected patients. Only few data are available for sub-Saharan Africa, where HIV and HEV are highly co-endemic, and where liver pathology is common in HIV-infected individuals. OBJECTIVES To assess the prevalence of HEV viremia, anti-HEV antibodies, and serum aminotransferase levels in HIV patients in Ghana and Cameroon. STUDY DESIGN We retrospectively surveyed a cross-section of patients who were enrolled in cohort studies in Ghana (West Africa), and Cameroon (Central Africa). Plasma samples from 1029 HIV patients from Ghana and 515 patients from Cameroon including 214 children were analyzed for HEV-RNA by two reverse transcription PCR methods. In a subset of 791 patients, anti-HEV IgG and IgM antibodies were analyzed. RESULTS No HEV-RNA was detected in any of the plasma samples of 1544 patients. HEV seroprevalence was high in adult HIV patients from Ghana (45.3%, n=402) and Cameroon (14.2%, n=289), but low in pediatric HIV patients from Cameroon (2.0%, n=100). Elevations of alanine aminotransferase and aspartate aminotransferase levels were common in adult patients from Ghana (20.8% and 25.4%) and Cameroon (38.9% and 69.8%). The prevalence of hepatitis B virus surface antigen was 11.8% and of hepatitis C virus antibodies 2.5% in our adult Cameroonian study population. CONCLUSIONS Acute or chronic HEV infections did not play a role in liver pathology in two HIV cohorts in Ghana and Cameroon. A better understanding of the epidemiology and genotype-specific characteristics of HEV infections in HIV patients in sub-Saharan Africa is needed.
Collapse
Affiliation(s)
- Torsten Feldt
- Clinical Research Unit, Bernhard Nocht Institute of Tropical Medicine, Bernhard-Nocht Str. 74, 20359 Hamburg, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Aghasadeghi MR, Mohraz M, Bahramali G, Aghakhani A, Banifazl M, Foroughi M, Ahmadi F, Eslamifar A, Sadat SM, Ramezani A. Frequency and Genotype of Hepatitis D Virus Infection in Patients Infected with HIV and Those Undergoing Hemodialysis. HEPATITIS MONTHLY 2013; 13:e7481. [PMID: 23914228 PMCID: PMC3728973 DOI: 10.5812/hepatmon.7481] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Revised: 11/17/2012] [Accepted: 04/06/2013] [Indexed: 01/10/2023]
Abstract
BACKGROUND Hepatitis D virus (HDV) is a defective virus dependent on hepatitis B virus (HBV) for its replication. Due to HDV transmission routes, patients undergoing hemodialysis and those with HIV infection are at risk of acquiring HDV. OBJECTIVES This study was aimed to determine the frequency and genotype of HDV infection among patients with HIV infection and those undergoing hemodialysis. PATIENTS AND METHODS 720 cases including 120 patients undergoing hemodialysis, and 600 patients with HIV infection were studied. All cases with positive results for HBsAg were evaluated for the presence of anti-HDV antibodies. Samples with Anti-HDV positive results were subjected to nested PCR for HDV-RNA confirmation, and sequenced for HDV genotype determination. RESULTS HBsAg was found in 9 (7.5%) of 120 patients undergoing hemodialysis, and 9 (1.5%) of 600 patients with HIV infection. 3 (33.3%) of patients undergoing hemodialysis with positive results for HBsAg, and 5 (55.5%) of cases with HIV infection and positive results for HBsAg, had positive findings for anti-HDV which were then subjected to nested PCR. The amplification results confirmed that in 3 (37.5%) samples HDV-RNA was detected. Overall 2.5% of patients undergoing hemodialysis, and 0.8% of cases infected with HIV had positive results for anti-HDV and 1.7% and 0.2% of cases undergoing hemodialysis and patients infected with HIV had positive findings for HDV-RNA respectively. All of the HDV isolates were clustered in clade 1. CONCLUSIONS The survey showed that overall HDV frequency was not high in our high risk cases. Therefore, practitioners and health care managers should become aware of the risk of dual infection with HBV and HDV especially in high risk patients.
Collapse
Affiliation(s)
| | - Minoo Mohraz
- Iranian Research Center for HIV/AIDS, Tehran, IR Iran
| | - Golnaz Bahramali
- Department of Hepatitis and AIDS, Pasteur Institute, Tehran, IR Iran
| | - Arezoo Aghakhani
- Department of Clinical Research, Pasteur Institute, Tehran, IR Iran
| | - Mohammad Banifazl
- Iranian Society for Support of Patients With Infectious Diseases, Tehran, IR Iran
| | | | - Farrokhlagha Ahmadi
- Nephrology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Ali Eslamifar
- Department of Clinical Research, Pasteur Institute, Tehran, IR Iran
- Corresponding authors: Amitis Ramezani, Department of Clinical Research, Pasteur Institute, Tehran, IR Iran. Tel.: +98-2166465147, Fax: +98-2166465147, E-mail: ; Ali Eslamifar, Department of Clinical Research, Pasteur Institute, Tehran, IR Iran. Tel.: +98-2166968852, Fax: +98-2166968852, E-mail:
| | - Seyed Mehdi Sadat
- Department of Hepatitis and AIDS, Pasteur Institute, Tehran, IR Iran
| | - Amitis Ramezani
- Department of Clinical Research, Pasteur Institute, Tehran, IR Iran
- Corresponding authors: Amitis Ramezani, Department of Clinical Research, Pasteur Institute, Tehran, IR Iran. Tel.: +98-2166465147, Fax: +98-2166465147, E-mail: ; Ali Eslamifar, Department of Clinical Research, Pasteur Institute, Tehran, IR Iran. Tel.: +98-2166968852, Fax: +98-2166968852, E-mail:
| |
Collapse
|
48
|
Kumar S, Subhadra S, Singh B, Panda BK. Hepatitis E virus: the current scenario. Int J Infect Dis 2013; 17:e228-33. [PMID: 23313154 DOI: 10.1016/j.ijid.2012.11.026] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 11/24/2012] [Accepted: 11/29/2012] [Indexed: 12/12/2022] Open
Abstract
Hepatitis E infection, caused by the hepatitis E virus (HEV), is a common cause of acute hepatitis in developing countries with poor sanitation and hygiene. The virus is classified into four genotypes (1-4) with one serotype. Genotypes 1 and 2 exclusively infect humans, whereas genotypes 3 and 4 also infect other animals, particularly pigs. In endemic areas, large outbreaks of acute hepatitis caused by viruses of genotype 1 or 2 frequently occur due to fecal-oral transmission, usually through contamination of drinking water. With a high attack rate in young adults (aged 15-45 years), the disease is particularly severe among pregnant women (20-30% mortality). HEV appears to be a zoonotic disease, with transmission from pigs, wild boars, and deer, or foodborne. Chronic infections are rare, except in immunosuppressed persons, such as organ transplant recipients. A subunit vaccine has been shown to be effective in preventing the clinical disease, but is not yet commercially available. Our understanding of HEV has undergone major changes in recent years and in this article we review the currently available information with regard to the molecular biology, pathobiology, and epidemiology of HEV infection. We also review the current therapeutic interventions and strategies being used to control HEV infection, with emphasis on possible approaches that could be used to develop an effective vaccine against HEV.
Collapse
Affiliation(s)
- Subrat Kumar
- School of Biotechnology, KIIT University, Campus-XI, Patia, Bhubaneswar 751024, Orissa, India.
| | | | | | | |
Collapse
|
49
|
Rapicetta M, Monarca R, Kondili LA, Chionne P, Madonna E, Madeddu G, Soddu A, Candido A, Carbonara S, Mura MS, Starnini G, Babudieri S. Hepatitis E virus and hepatitis A virus exposures in an apparently healthy high-risk population in Italy. Infection 2012; 41:69-76. [DOI: 10.1007/s15010-012-0385-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 12/07/2012] [Indexed: 10/27/2022]
|
50
|
HDAg-L variants in covert hepatitis D and HBV occult infection among Amerindians of Argentina: new insights. J Clin Virol 2012; 54:223-8. [DOI: 10.1016/j.jcv.2012.04.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 03/07/2012] [Accepted: 04/20/2012] [Indexed: 12/15/2022]
|