Host risk factors and autochthonous hepatitis E infection

Area of Science:

• Hepatology
• Virology
• Epidemiology

Background:

• Autochthonous hepatitis E infection in developed countries is primarily caused by hepatitis E virus (HEV) genotypes 3 and 4.
• The disease predominantly affects middle-aged and elderly men, suggesting host factors may influence disease presentation.

Purpose of the Study:

• To identify potential host risk factors for symptomatic autochthonous hepatitis E infection.
• To investigate the association between alcohol consumption and hepatitis E infection in a patient cohort.

Main Methods:

• Retrospective review of 53 patients with symptomatic hepatitis E infection.
• Comparison of patient data with 564 controls, adjusting for age and sex.
• Determination of anti-HEV seroprevalence in controls and patients with chronic liver disease.

Main Results:

• Patients with hepatitis E were significantly more likely to consume at least 22 units of alcohol weekly (OR=9.4).
• Anti-HEV IgG seroprevalence increased with age in controls but showed no sex difference.
• Patients with alcoholic liver disease exhibited lower anti-HEV IgG seroprevalence (4.8%) compared to controls (13.8%).

Conclusions:

• High alcohol consumption (≥22 U/week) is associated with clinically apparent hepatitis E infection.
• The low seroprevalence of HEV in patients with alcoholic liver disease may indicate a "culled population" with severe outcomes.
• Individuals with alcoholic liver disease may experience severe, high-mortality disease upon HEV exposure.