Unexpected high seroprevalence of hepatitis E virus in patients with alcohol-related cirrhosis

• Published in: PloS one Vol. 14; no. 10; p. e0224404
• Main Authors: Fantilli, Anabella C., Trinks, Julieta, Marciano, Sebastián, Zárate, Fabián, Balderramo, Domingo C., Wassaf, Maribel G. Martínez, Haddad, Leila, Gadano, Adrián, Debes, José D., Pisano, María B., Ré, Viviana E.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 24.10.2019; Public Library of Science (PLoS)
• Subjects: Acute Disease; Adult; Aged; Aged, 80 and over; Alcohol; Alcohol use; Alcoholism; Alcohols; Analysis; Biology and life sciences; Care and treatment; Case-Control Studies; Cirrhosis; Cross-Sectional Studies; Drinking (Alcoholic beverages); Female; Health aspects; Health risks; Hepatitis; Hepatitis E; Hepatitis E - complications; Hepatitis E - epidemiology; HIV; Hospitals; Human immunodeficiency virus; Humans; Immunoglobulin G; Immunoglobulin M; Infection; Infections; Liver cirrhosis; Liver Cirrhosis, Alcoholic - complications; Liver Cirrhosis, Alcoholic - virology; Liver diseases; Male; Medical research; Medicine and Health Sciences; Middle Aged; People and places; Physical Sciences; Population; Prevalence studies (Epidemiology); Ribonucleic acid; Risk analysis; Risk Factors; RNA; Seroepidemiologic Studies; Serology; Studies; Viruses; Young Adult; United States > US; Argentina
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0224404

Little is known about hepatitis E virus (HEV) infection in patients with cirrhosis. The aim of the present study was to describe the frequency of HEV infection and associated risk factors in patients with cirrhosis from Argentina. We evaluated HEV seroprevalence (IgG anti-HEV) and acute infections (IgM and RNA) in patients with cirrhosis (n = 140) vs. healthy controls (n = 300). Additionally, we compared the same outcomes in individuals with alcohol-related cirrhosis (n = 43) vs. patients with alcohol use disorder (without cirrhosis, n = 72). The overall HEV seroprevalence in the cohort of subjects with cirrhosis was 25% (35/140), compared to 4% in the healthy control group [12/300; OR = 8; (95% CI = 4-15.99); p<0.05]. HEV seropositivity was significantly higher in alcohol-related cirrhosis compared to other causes of cirrhosis [39.5% vs. 12.4%; OR = 4.71; (95% CI = 1.9-11.6); p<0.05] and to healthy controls [OR = 15.7; (95% CI = 6.8-36.4); p = 0.0001]. The HEV seroprevalence in alcoholic-related cirrhosis vs. with alcohol use disorder was 39.5% vs. 12.5% [OR = 4.58; (95% CI = 1.81-11.58); p<0.001]. We found a high seroprevalence of HEV in patients with cirrhosis and in individuals with alcohol use disorder. The simultaneous presence of both factors (cirrhosis + alcohol) showed more association to HEV infection. Larger studies with prospective follow up are needed to further clarify this interaction.