HEPATITIS E VIRUS (HEV) INFECTION IN PATIENTS WITH CIRRHOSIS AND IN LIVER TRANSPLANT RECIPIENTS IN BUENOS AIRES, ARGENTINA: EXPLORING ASSOCIATED RISK FACTORS

PISANO MB; TRINKS J; MARCIANO S; FANTILLI A; HADDAD L; GADANO A; DEBES J; RÉ VE

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

Asociación Latinoamericana para el estudio del hígado (ALEH)

BACKGROUND: HEV infection has been associated with self-limiting acute hepatitis, but progression to chronic hepatitis was recently reported among immunosuppressed populations. Cirrhosis and liver transplantation have also been postulated as predisposing factors for HEV infection. AIM: To describe HEV infection and associated factors in patients with cirrhosis and in liver transplant recipients in Buenos Aires, Argentina. PATIENTS AND METHODS: Serum samples were obtained from consecutive patients with cirrhosis and liver transplant recipients between June 2017 and April 2018. Detection of IgG and IgM anti-HEV antibodies, and HEV RNA were carried out by ELISA (Dia.Pro, Italy) and ORF-2 PCR, respectively. Statistical analyses were performed to examine associations between anti-HEV and cause of cirrhosis, transplantation, age, gender, bilirubin and transaminase levels. RESULTS: Sixty-one patients were included in this study: 41 (67.2%) were patients with cirrhosis and 20 (32.8%) were liver transplant recipients and medically immunosuppressed. The main demographic, clinical and serological characteristics are shown in the table. Nine liver transplant recipients (45%) were anti-HEV IgG[+], 8 of them were also anti-HEV IgM[+]. Twelve patient with cirrhosis (29.2%) were anti-HEV IgG[+], 9 of them were also anti-HEV IgM[+]. The presence of anti-HEV was documented in 54.5% of patients with alcoholic cirrhosis, versus 20% of those without alcoholic cirrhosis (P=0.03; odds ratio 4.8; 95% CI 1.1-21.2). HEV RNA was detected in 28.6% of seropositive transplant recipients and in 16.7% of seropositive patients with cirrhosis.CONCLUSIONS: Higher HEV seroprevalence was detected in patients with cirrhosis and in liver transplant recipients when compared to the same populations in European countries, and to immunocompetent and immunosuppressed populations in Argentina. Further research is needed to ascertain whether alcoholic cirrhosis can be a potential risk factor for acquiring HEV