Prevalence and impact of hepatitis E virus infection among persons with chronic hepatitis B living in the US and Canada

David R. McGivern, Hsing Hua S. Lin, Junyao Wang, Tiffany Benzine, Harry L.A. Janssen, Mandana Khalili, Mauricio Lisker-Melman, Robert J. Fontana, Steven H. Belle, Michael W. Fried

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Abstract

Background. Patients with chronic hepatitis B virus (HBV) may experience spontaneous biochemical flares of liver disease activity. This study aimed to determine (i) the prevalence of prior and possible acute hepatitis E virus (HEV) infection among persons with chronic HBV and (ii) whether HEV infection is associated with liver disease flares among persons with chronic HBV. Methods. Serum from a random sample of 600 adults in the Hepatitis B Research Network Cohort Study was tested for HEV RNA and anti-HEV IgM and IgG. Logistic regression models were used to estimate crude and adjusted odds ratios of anti-HEV prevalence for participant characteristics. Results. Anti-HEV IgG and IgM seroprevalence was 28.5% and 1.7%, respectively. No participants had detectable HEV RNA. Of the 10 anti-HEV IgM+ participants, only 1 had elevated serum ALT at seroconversion. The odds of anti-HEV seropositivity (IgG+ or IgM+) were higher in older participants, males, Asians, less educated people, and those born outside the United States and Canada. Conclusions. Acute HEV infection is a rare cause of serum ALT flares among persons with chronic HBV. The high seroprevalence of anti-HEV IgG among the chronic HBV patients is strongly associated with various demographic factors in this largely Asian American cohort.

Original languageEnglish
JournalOpen Forum Infectious Diseases
Volume6
Issue number5
DOIs
StatePublished - Jan 1 2019

Keywords

  • Acute hepatitis
  • Alanine aminotransferase
  • Flare
  • HBV
  • HEV

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    McGivern, D. R., Lin, H. H. S., Wang, J., Benzine, T., Janssen, H. L. A., Khalili, M., Lisker-Melman, M., Fontana, R. J., Belle, S. H., & Fried, M. W. (2019). Prevalence and impact of hepatitis E virus infection among persons with chronic hepatitis B living in the US and Canada. Open Forum Infectious Diseases, 6(5). https://doi.org/10.1093/ofid/ofz175