Variability of Hepatitis E Seroprevalence in Hemodialysis Patients: A Prospective Analysis

MARÍA BELÉN PISANO ; JAMES LEATHERS; DOMINGO BALDERRAMO; FERNANDO DIEHL; MARIBEL MARTÍNEZ WASSAF; CRISTANI, CARLA; DI COLA, GUADALUPE; JOSÉ DEBES,; VIVIANA E. RÉ

Congreso; XXV Congreso de la Asociación Latinoamericana para el estudio del hígado (ALEH); 2018

Asociación Latinoamericana para el estudio del hígado (ALEH)

Introduction: Hepatitis E virus (HEV) genotypes 3 has beend associated with chronic hepatitis in immunosuppressed individuals. Several studies have shown that patients undergoing hemodialysis (HD) have a higher seroprevalence of HEV than the general population. The dynamics of HEV in this population is unclear.Objectives: To assess the incidence of new and chronic HEV infections as well as temporal variations in HEV seroprevalence in patients undergoing HD Methods: We prospectively evaluated individuals with end stage renal disease (ESRD) undergoing HD at a Hospital Privado in Córdoba, Argentina, between November 2014 and November 2017. All individuals underwent serological reassessment at either 6 or 12 months post-initial evaluation. Thirty individuals underwent 2 additional serological assessments (separated by ≥6 months) over a 36-month period (total of 4 assessments). Detection of anti-HEV IgG and IgM was performed by ELISA and measurement of HEV RNA was performed using nested-PCR.Results: Of 51 individuals who were initially seronegative for anti-HEV IgG, 5 underwent seroconversion, representing an incidence of 9.8% (5/51). Four of five patients who underwent seroconversion reverted back to a negative anti-HEV IgG status ≥6months later. One of four patients who reverted back to a negative anti-HEV IgG status became newly seropositive at the next serological reassessment. Only one patient remained seropositive throughout the course of the study. All samples, including those who were positive for anti-HEV IgG, were negative for anti-HEV IgM. No subjects tested positive for HEV RNA during the entire study period and there were no chronic infections.Conclusions: Our results demonstrate alternating seropositivity for HEV in individuals undergoing HD, suggesting that positivity for anti-HEV IgG may not indicate persistent immunity to the virus in this population.