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The Burden of Hepatitis E Infection in Chronic Liver Diseases in Croatia
Anna Mrzljak1,2, Petra Dinjar-Kujundzic1, Lorena Jemersic3
1Department of Medicine, Merkur University Hospital, Zagreb, Croatia.
Insights
Chronic liver disease patients showed 15.1% past hepatitis E virus (HEV) exposure. However, no active HEV infection was found, indicating low risk of acute or chronic hepatitis E in this population.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis E virus (HEV) infection poses a significant risk for decompensation and mortality in patients with chronic liver disease (CLD).
- Understanding HEV seroprevalence and active infection rates is crucial for managing CLD patients.
Purpose of the Study:
- To determine the seroprevalence of HEV exposure in CLD patients.
- To investigate the presence of active HEV infection (IgM antibodies and RNA) in this cohort.
Main Methods:
- Screened 438 CLD patients for HEV-IgG antibodies.
- Utilized ELISA for HEV-IgM antibody detection in IgG-positive samples.
- Employed RT-PCR to detect HEV RNA in IgM-positive cases.
Main Results:
- HEV-IgG antibodies were detected in 15.1% of CLD patients, indicating past exposure.
- A small subset (4.5%) of IgG-positive patients also had detectable IgM antibodies.
- No patients tested positive for HEV RNA, signifying no acute or chronic HEV infection.
Conclusions:
- Previous exposure to HEV is common in CLD patients, consistent with European regional data.
- Despite seroprevalence, no evidence of active HEV infection was found in this CLD cohort.
- The risk of acute or chronic hepatitis E appears low in CLD patients in this region.
Abstract:
In patients with chronic liver disease (CLD), hepatitis E virus (HEV) may lead to decompensation and death. We tested 438 CLD patients (71.0% male; age 23-84 years) for HEV-IgG antibodies. Reactive samples were tested for HEV-IgM antibodies using ELISA. IgM positive samples were tested for HEV RNA using RT-PCR. HEV-IgG antibodies were found in 15.1% of patients, whereas 4.5% of IgG positive patients had detectable IgM antibodies. Not a single patient tested HEV RNA positive. Seroprevalence increased with age, from 9.7% (<45 years) to 17.4% (>60 years, p = 0.368). There was no difference in HEV-IgG seropositivity related to gender, level of education, geographic region, area of residence, liver disease, or hepatocellular carcinoma presence. Previous exposure to HEV was detected in 15.1% of patients, corresponding with the data from other endemic European regions. Despite the high local exposure, we did not find any evidence of acute or chronic hepatitis E among CLD patients.
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