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 V

Punta Cana

Congreso; XXV Congreso de la Asociación Latinoamericana para el Estudio del Hígado; 2018

Asociación Latinoamericana para el Estudio de las Enfermedades del Hígado (ALEH)

Background. HEV infection has been associated with self-limiting acute hepatitis, but progression to chronic hepatitis has been recently reported among immunosuppressed populations. Cirrhosis and liver transplantation have also been postulated as predisposing factors for HEV infection. Aim. To estimate the prevalence of HEV infection and associated factors in patients with cirrhosis and in liver transplant recipients in Buenos Aires, Argentina. Material and methods. Serum samples were obtained from consecutive patients with cirrhosis and liver trans- plant recipients between June 2017 and April 2018. Detection of anti-HEV IgG and IgM antibodies, and HEV RNA were carried out by ELISA (Dia.Pro, Italy) and ORF-2 PCR, respectively. Bivariate statistics were used to identify factors associated with positive anti-HEV IgG antibodies. Results. Sixty-one patients were included. 41 (67.2%) patients with cirrhosis and 20 (32.8%) liver transplant recipients. The main demographic, clinical and serological characteristics are shown in the table 1. Nine liver transplant recipients (45 %; 95%CI 23% - 68%) were anti- HEV IgG[+], 8 of whom were also anti-HEV IgM[+]. Twelve patient with cirrhosis (29.2%; 95%CI 16%-46%) were anti- HEV IgG[+], 9 of whom were also anti-HEV IgM[+]. The presence of anti-HEV was documented in 54.5% of patients with alcoholic cirrhosis vs. 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 (Table 1). Conclusions. Higher HEV seroprevalence was detected in patients with cirrhosis and in liver transplant recipients when compared to the same populations from European countries, and to immunocompetent and immunosuppressed populations from Argentina. Further research is needed to ascertain whether alcoholic cirrhosis can be a potential risk factor for HEV infection. Conflict of interest. None.