Hepatitis E virus co-infection in HIV-infected patients in Foggia and Naples in southern Italy.
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).
['Scotto|Gaetano|G|', 'Grisorio|Benvenuto|B|', 'Filippini|Pietro|P|', 'Ferrara|Sergio|S|', 'Massa|Salvatore|S|', 'Bulla|Fabio|F|', 'Martini|Salvatore|S|', 'Filippini|Alberico|A|', 'Tartaglia|Alessandra|A|', 'Lo Muzio|Lorenzo|L|', 'Fazio|Vincenzina|V|']
D000328:Adult D015153:Blotting, Western D015331:Cohort Studies D060085:Coinfection D005260:Female D006678:HIV D015658:HIV Infections D006508:Hepatitis Antibodies D016751:Hepatitis E D016752:Hepatitis E virus D006521:Hepatitis, Chronic D006801:Humans D007074:Immunoglobulin G D007075:Immunoglobulin M D007558:Italy D008099:Liver D008297:Male D008875:Middle Aged D011446:Prospective Studies D012367:RNA, Viral D016036:Seroepidemiologic Studies
Hepatitis E seroprevalence HIV infection co-infection HBV-HCV epidemiology