Increased HEV seroprevalence in HIV-infected patients with low CD4+ cell count in Argentina.

JOSÉ DEBES, ; MARIBEL MARTÍNEZ WASSAF,; MARIA BELEN PISANO,; LEONARDO MARIANELLI,; NATALIA FRASSONE,; MARIA BEATRIZ ISA, ; ESTEFANIA BALLARI,; VIVIANA RE.

Cincinati

Encuentro; HIV & Liver Disease 2014 5th Biennial Meeting; 2014

Universidad de Cincinati

Hepatitis E virus (HEV) is a single-stranded RNA virus that can cause hepatitis in an epidemic fashion. In immunocompetent individuals, infection with HEV usually leads to silent seroconversion or to acute self-limited disease. Several reports suggest an increased rate of seroprevalence of HEV in immunosuppressed individuals, particularly those undergoing solid-organ transplantation. In this setting, HEV can develop into a chronic infection. The data is less clear in patients infected with human immunodeficiency virus (HIV). Some reports suggest an increase seroprevalence of HEV in this population, while others found no difference. In the following study we analyzed serum samples from HIV-infected patients in central Argentina. We performed third generation enzyme immunoassay for determination of IgG specific antibodies against HEV in 95 patients infected with HIV. These samples included patients with stable CD4 count and a subgroup of patients with low CD4 count, which were scheduled to start antiretroviral therapy (ART). As controls we used a cohort of 433 samples from HIV-negative patients that were previously evaluated for HEV in our center. In the HIV-positive group we found 8 of 95 samples to be positive for HEV (8.8%), compared to 19 of 433 samples (4.4%) in the control group. Interestingly, the subgroup of 27 patients that were scheduled to start ART had 5 samples positive for HEV (18%). This group had a much lower CD4 count when compared to the general HIV cohort (average CD4 count 99/mm3 vs 527/mm3 respectively). Our study found an increased seroprevalence of HEV in HIV-infected patients compared to controls in Argentina. This increased prevalence seems to be directly related to a low CD4 count.