Evidence of Hepatitis E virus (HEV) infection in solid organ recipients and dialyzed patients from Córdoba

LOTTO M; PISANO MB,; MARTÍNEZ WASSAF M, ; BALDERRAMO D,; CONTIGIANI M, ; DEBES J; , RÉ V

Cordoba

Jornada; XVI Jornada de Investigación Científica.; 2015

Secretaría de Ciencia y Tecnología de la Facultad de Ciencias Médicas,

Hepatitis E Virus (HEV) is a zoonotic virus which causes acute hepatitis of enteric transmission. Although its presentation is mainly in an asymptomatic form, complications can occur in pregnant patients and those with previous hepatic disorder. Many publications around the world suggest that immunosuppressed subjects infected with HEV genotype 3 might develop chronic infections. It has been documented the circulation of this variant in Córdoba in water and pork feces. The aim of this study was to determine HEV prevalence in dialyzed and organ recipient patients, to analyze the risk factors associated with the infection, and to compare them with previously obtained data from general population.IgG and IgM anti-HEV prevalence (EIA, Diapro, Milan) and HEV RNA (RT-Nested PCR) presence were determined in samples of dialyzed (HD, n=84) and organ recipient patients (Tx, n=57; Tx-hepatic, n=12; Tx-renal, n= 45) attended in healthcare centers from Córdoba. All of them had previously signed consent forms (CIEIS HP 4-231/14). All subjects were analyzed according to their social habits and the presence of potential risk factors (consumption of pork and/ or fish meat, access to potable water, history of transfusion and travels). Four hundred and thirty three previously studied subjects were used as control group (CIEIS OR-001). Univariate analyses (X2 and Fisher) were used to compare serological markers between populations and to evaluate risk factors, considering a statistical significance lower than 0.05.The overall percentage of positivity for IgG anti-HEV was 9.9% (14/141), significantly higher than the one found in the control group (4.4% - 19/433) (p=0.05). In solid organ recipients this value was 8.8%, although no IgM anti-HEV was found. In dialyzed patients it was 10.7% for IgG whereas it reached 5.9% for IgM. No significant association was found between serological state and variables analyzed. All samples resulted HEV RNA negative. These results provide the first evidence of HEV circulation in immunosuppressed population from Córdoba, showing a higher positive percentage of IgG when compared with general population. The findings presented in this work underline the need to increase clinical and epidemiological knowledge about HEV in these population, susceptible to develop chronic infection.