Unexpected high seroprevalence of hepatitis E virus in patients with alcohol-related cirrhosis


Autoři: Anabella C. Fantilli aff001;  Julieta Trinks aff002;  Sebastián Marciano aff004;  Fabián Zárate aff006;  Domingo C. Balderramo aff007;  Maribel G. Martínez Wassaf aff008;  Leila Haddad aff004;  Adrián Gadano aff004;  José D. Debes aff009;  María B. Pisano aff001;  Viviana E. Ré aff001
Působiště autorů: Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina aff001;  Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina aff002;  Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB)—CONICET—Instituto Universitario del Hospital Italiano (IUHI)—Hospital Italiano (HIBA), Buenos Aires, Argentina aff003;  Sección de Hepatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina aff004;  Departamento de Investigación, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina aff005;  Hospital Córdoba, Córdoba, Argentina aff006;  Departamento de Gastroenterología, Hospital Privado Universitario de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba, Argentina aff007;  LACE Laboratorios, Córdoba, Argentina aff008;  Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America aff009
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224404

Souhrn

Introduction

Little is known about hepatitis E virus (HEV) infection in patients with cirrhosis. The aim of the present study was to describe the frequency of HEV infection and associated risk factors in patients with cirrhosis from Argentina.

Materials and methods

We evaluated HEV seroprevalence (IgG anti-HEV) and acute infections (IgM and RNA) in patients with cirrhosis (n = 140) vs. healthy controls (n = 300). Additionally, we compared the same outcomes in individuals with alcohol-related cirrhosis (n = 43) vs. patients with alcohol use disorder (without cirrhosis, n = 72).

Results

The overall HEV seroprevalence in the cohort of subjects with cirrhosis was 25% (35/140), compared to 4% in the healthy control group [12/300; OR = 8; (95% CI = 4–15.99); p<0.05]. HEV seropositivity was significantly higher in alcohol-related cirrhosis compared to other causes of cirrhosis [39.5% vs. 12.4%; OR = 4.71; (95% CI = 1.9–11.6); p<0.05] and to healthy controls [OR = 15.7; (95% CI = 6.8–36.4); p = 0.0001]. The HEV seroprevalence in alcoholic-related cirrhosis vs. with alcohol use disorder was 39.5% vs. 12.5% [OR = 4.58; (95% CI = 1.81–11.58); p<0.001].

Conclusion

We found a high seroprevalence of HEV in patients with cirrhosis and in individuals with alcohol use disorder. The simultaneous presence of both factors (cirrhosis + alcohol) showed more association to HEV infection. Larger studies with prospective follow up are needed to further clarify this interaction.

Klíčová slova:

Alcohol consumption – Alcohols – Argentina – Cirrhosis – Chronic liver disease – Medical risk factors – Primary biliary cirrhosis – Hepatitis E virus


Zdroje

1. (WHO) WHO. Fact Sheet HEV. 2017.

2. Smith DB, Simmonds P, Izopet J, Oliveira-Filho EF, Ulrich RG, Johne R, et al. Proposed reference sequences for hepatitis E virus subtypes. J Gen Virol. 2016;97:537–542. doi: 10.1099/jgv.0.000393 26743685

3. Pisano MB, Martinez-Wassaf MG, Mirazo S, Fantilli A, Arbiza J, Debes JD, et al. Hepatitis E virus in South America: The current scenario. Liver Int. 2018;38(9):1536–46. doi: 10.1111/liv.13881 29788538

4. Kamar N, Selves J, Mansuy JM, Ouezzani L, Peron JM, Guitard J, et al. Hepatitis E virus and chronic hepatitis in organ-transplant recipients. N Engl J Med. 2008;358:811–7. doi: 10.1056/NEJMoa0706992 18287603

5. Ramachandran J, Eapen C, Kang G, Abraham P, Hubert DDJ, Kurian G, et al. Hepatitis E superinfection produces severe decompensation in patients with chronic liver disease. J Gastroenterol Hepatol. 2004;19(2):134–8. doi: 10.1111/j.1440-1746.2004.03188.x 14731121

6. Neukam K, Barreiro P, Macías J, Avellón A, Cifuentes C, Martín-Carbonero L, et al. Chronic hepatitis e in HIV patients: Rapid progression to cirrhosis and response to oral ribavirin. Clin Infect Dis. 2013;57(3):465–8. doi: 10.1093/cid/cit224 23575198

7. Mellgren Å, Karlsson M, Karlsson M, Lagging M, Wejstål R, Norder H. High seroprevalence against hepatitis E virus in patients with chronic hepatitis C virus infection. J Clin Virol [Internet]. 2017;88:39–45. Available from: doi: 10.1016/j.jcv.2017.01.005 28160727

8. Kamar N, Izopet J, Pavio N, Aggarwal R, Labrique A, Wedemeyer H, et al. Hepatitis E virus infection. Nat Rev. 2017;3:17086.

9. Abravanel F, Lhomme S, Chapuy-Regaud S, Mansuy JM, Muscari F, Sallusto F. Hepatitis E virus reinfections in solid-organ-transplant recipients can evolve into chronic infections. J Infect Dis. 2014;209:1900–6. doi: 10.1093/infdis/jiu032 24436450

10. Haagsma E, Niesters H, van den Berg A, Riezebos-Brilman A, Porte R, Vennema H, et al. Prevalence of Hepatitis E Virus Infection in Liver Transplant Recipients. Liver Transplant. 2009;15:1225–1228.

11. Kumar Acharya S, Kumar Sharma P, Singh R, Kumar Mohanty S, Madan K, Kumar Jha J, et al. Hepatitis E virus (HEV) infection in patients with cirrhosis is associated with rapid decompensation and death. J Hepatol. 2007;46(3):387–94. doi: 10.1016/j.jhep.2006.09.016 17125878

12. Gérolami R, Moal V, Colson P. Chronic hepatitis E with cirrhosis in a kidney-transplant recipient. N Engl J Med. 2008;358:859–60. doi: 10.1056/NEJMc0708687 18287615

13. Hoan NX, Tong H Van, Hecht N, Sy BT, Marcinek P, Meyer CG, et al. Hepatitis E Virus Superinfection and Clinical Progression in Hepatitis B Patients. EBioMedicine [Internet]. 2015;2(12):2080–6. Available from: doi: 10.1016/j.ebiom.2015.11.020 26844288

14. Marion-Audibert AM, Tesse S, Graillot E, Phelip G, Radenne S, Duperret S, et al. Lethal acute HEV superinfection on hepatitis B cirrhosis. Gastroenterol Clin Biol. 2010;34:334–6. doi: 10.1016/j.gcb.2010.02.003 20494538

15. Riveiro-Barciela M, Buti M, Homs M, Campos-Varela I, Cantarell C, Crespo M, et al. Cirrhosis, liver transplantation and HIV infection are risk factors associated with hepatitis E virus infection. PLoS One. 2014;9:e103028. doi: 10.1371/journal.pone.0103028 25068388

16. Yang H, Wu J, Yuan Y, Huang W, Jia B. Retrospectively Seroprevalence Study on Anti-HEV- IgG antibody in patients with chronic hepatitis or liver cirrhosis in a Chinese teaching hospital. J Med Virol. 2019;

17. Bricks G, Senise JF, Pott H Jr, Grandi G, Dimas C, Hamilton A, et al. Previous hepatitis E virus infection, cirrhosis and insulin resistance in patients with chronic Hepatitis C. Brazilian J Infect Dis [Internet]. 2019;23(1):45–52. Available from: https://doi.org/10.1016/j.bjid.2019.02.002

18. Akyüz F, Çavuş B, Pınarbaşı B, Bozacı M, Baran B, Akyuz U, et al. Cryptogenic liver cirrhosis and hepatitis E virus (HEV): Are they related? Ann Hepatol. 2019;18:585–9. doi: 10.1016/j.aohep.2019.01.007 31130469

19. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Management of alcohol-related liver disease. J Hepatol. 2018;69:154–181. doi: 10.1016/j.jhep.2018.03.018 29628280

20. Huang FF, Haqshenas G, Guenette DK, Halbur PG, Schommer SK, Pierson FW, et al. Detection by Reverse Transcription-PCR and Genetic Characterization of Field Isolates of Swine Hepatitis E Virus from Pigs in Different Geographic Regions of the United States. J Clin Microbiol. 2002;40:1326–1332. doi: 10.1128/JCM.40.4.1326-1332.2002 11923352

21. Aballay L, Osella A, Celi A, Díaz M del P. Overweight and obesity: Prevalence and their association with some social characteristics in a random sample population-based study in Córdoba city, Argentina. Obes Res Clin Pr. 2009;3:75–83.

22. Munné MS, Altabert NR, Otegui M. LO, Vladimirsky SN, Moreiro R, Espul MP, et al. Updating the knowledge of hepatitis E: New variants and higher prevalence of anti-HEV in Argentina. Ann Hepatol. 2014;13(5):496–502. 25152981

23. Frias M, López-López P, Rivero A, Rivero-Juarez A. Role of Hepatitis e Virus Infection in Acute-on-Chronic Liver Failure. Biomed Res Int. 2018;2018.

24. Dalton HR, Webb GW, Norton BC, Woolson KL. Hepatitis e Virus: Time to Change the Textbooks. Dig Dis. 2016;34(4):308–16. doi: 10.1159/000444468 27170383

25. Martínez Wassaf MG, Pisano MB, Barril PA, Elbarcha OC, Pinto MA, Mendes de Oliveira J, et al. First detection of hepatitis E virus in Central Argentina: Environmental and serological survey. J Clin Virol [Internet]. 2014;61(3):334–9. Available from: doi: 10.1016/j.jcv.2014.08.016 25213209

26. Jardi R, Crespo M, Homs M, van den Eynde E, Girones R, Rodriguez-Manzano J, et al. HIV, HEV and cirrhosis: Evidence of a possible link from eastern Spain. HIV Med. 2012;13(6):379–83. doi: 10.1111/j.1468-1293.2011.00985.x 22257075

27. Sha S, Gupta B, Shrestha A, Rodin H, Boonstra A, Debes J. Association between liver fibrosis and HEV seroprevalence among HIV-positive individuals in Nepal. J viral Hepat. 2018;211–224. doi: 10.1111/jvh.12995

28. Albillos A, Lario M, Álvarez-Mon M. Cirrhosis-associated immune dysfunction: distinctive features and clinical relevance. J Hepato. 2014;61:1385–96.

29. Sipeki N, Antal-Szalmas P, Lakatos P, Papp M. Immune dysfunction in cirrhosis. World J Gastroenterol. 2014;20:2564–77. doi: 10.3748/wjg.v20.i10.2564 24627592

30. Dalton H, Bendall R, Rashid M, Ellis V, Ali R, Ramnarace R, et al. Host risk factors and autochthonous hepatitis E infection. Eur J Gastroenterol Hepatol. 2011;23(12):1200–5. doi: 10.1097/MEG.0b013e32834ca4da 21941192

31. Said B, Ijaz S, Kafatos G, Booth L, Thomas H, Walsh A, et al. Hepatitis E outbreak on cruise ship. Emerg Infect Dis. 2009;15:1738–44. doi: 10.3201/eid1511.091094 19891860

32. Bala S, Marcos M, Gattu A, Catalano D, Szabo G. Acute Binge Drinking Increases Serum Endotoxin and Bacterial DNA Levels in Healthy Individuals. PLoS One. 2014;9:e96864. doi: 10.1371/journal.pone.0096864 24828436

33. Szabo G, Saha B. Alcohol’s Effect on Host Defense. Alcohol Res Curr Rev. 2015;37(2):159–70.


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2019 Číslo 10