Hepatitis E Virus Infection in Patients with Systemic and Cutaneous Lupus Erythematosus

Area of Science:

• Immunology
• Infectious Diseases
• Rheumatology

Background:

• Systemic lupus erythematosus (SLE) and cutaneous lupus erythematosus (CLE) are autoimmune diseases with complex genetic and environmental causes.
• Hepatitis E virus (HEV) prevalence varies geographically, with Italian studies showing significant regional differences.
• Understanding co-infections and their impact on autoimmune conditions is crucial for patient management.

Purpose of the Study:

• To determine the seroprevalence of Hepatitis E virus (HEV) in patients diagnosed with Systemic Lupus Erythematosus (SLE) and Cutaneous Lupus Erythematosus (CLE).
• To investigate potential associations between HEV infection and specific lupus erythematosus subtypes.
• To explore possible risk factors and pathogenetic mechanisms linking HEV to CLE and SLE.

Main Methods:

• Serum samples from 138 patients (92 SLE, 46 CLE) attending a Lupus Clinic were analyzed.
• Detection of anti-HEV immunoglobulin G (IgG) and M (IgM) antibodies using commercial ELISA kits.
• Statistical analysis to compare HEV prevalence between SLE and CLE groups and assess risk factors.

Main Results:

• HEV seroprevalence was significantly higher in the CLE group (23.9%) compared to the SLE group (7.6%).
• Anti-HEV positive results were more frequent in patients with CLE.
• While no definitive risk factors were identified, increased odds of HEV positivity were noted in CLE patients with animal contact or raw seafood consumption.

Conclusions:

• CLE patients exhibit a higher prevalence of HEV infection compared to SLE patients.
• Potential mechanisms, including molecular mimicry related to skin antigens or genetic predisposition, may explain increased HEV susceptibility in CLE.
• Further research is warranted to elucidate the interplay between HEV and lupus pathogenesis, especially in CLE.