Hepatitis E in Australian HIV-infected patients: an under-recognised pathogen?

Area of Science:

• Hepatology
• Virology
• Infectious Diseases

Background:

• Hepatitis E virus (HEV) can cause chronic hepatitis in patients with human immunodeficiency virus (HIV).
• HEV seroprevalence in Australia is generally low, but unstudied in HIV-infected populations.
• HEV infection poses a risk for liver disease progression in immunocompromised individuals.

Purpose of the Study:

• To determine the seroprevalence of HEV in Australian HIV-infected patients.
• To compare HEV seroprevalence in HIV patients with normal versus abnormal liver function.
• To investigate the impact of HEV on liver function, particularly in those with hepatitis C co-infection.

Main Methods:

• Plasma samples from 191 HIV patients were tested for HEV antibodies.
• HEV RNA was detected using polymerase chain reaction in seropositive samples.
• Patients were categorized based on liver function tests and hepatitis C co-infection status.

Main Results:

• HEV antibodies were found in 8% of HIV patients with normal liver function and 4.4% with biochemical hepatitis.
• HIV patients with HEV and hepatitis C co-infection showed significantly higher alanine aminotransferase levels.
• HEV-positive patients with normal liver function were more likely to be foreign-born.

Conclusions:

• The seroprevalence of HEV is elevated in this Australian HIV-infected cohort compared to the general population.
• HEV co-infection, especially with hepatitis C, significantly worsens liver enzyme elevation.
• HEV infection may play a role in the development of abnormal liver function in HIV patients.