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

doi:10.1093/ofid/ofz175

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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2 Scopus citations

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 language	English
Journal	Open Forum Infectious Diseases
Volume	6
Issue number	5
DOIs	https://doi.org/10.1093/ofid/ofz175
State	Published - May 1 2019

Keywords

Acute hepatitis
Alanine aminotransferase
Flare
HBV
HEV

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10.1093/ofid/ofz175

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McGivern, David R. ; Lin, Hsing Hua S. ; Wang, Junyao ; Benzine, Tiffany ; Janssen, Harry L.A. ; Khalili, Mandana ; Lisker-Melman, Mauricio ; Fontana, Robert J. ; Belle, Steven H. ; Fried, Michael W. / Prevalence and impact of hepatitis E virus infection among persons with chronic hepatitis B living in the US and Canada. In: Open Forum Infectious Diseases. 2019 ; Vol. 6, No. 5.

@article{a7264db7f21e4d81a20f4a368beece72,

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

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.",

keywords = "Acute hepatitis, Alanine aminotransferase, Flare, HBV, HEV",

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

note = "Funding Information: Financial support. This work was supported by the National Institute of Diabetes and Digestive and Kidney Disease grant U01 DK082867 to Dr Michael W. Fried and U01 DK082864 to Dr Steven H. Belle as an ancillary study of the Hepatitis B Research Network. Publisher Copyright: {\textcopyright} 2019 Oxford University Press. All rights reserved.",

year = "2019",

month = may,

day = "1",

doi = "10.1093/ofid/ofz175",

language = "English",

volume = "6",

journal = "Open Forum Infectious Diseases",

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Prevalence and impact of hepatitis E virus infection among persons with chronic hepatitis B living in the US and Canada. / McGivern, David R.; Lin, Hsing Hua S.; Wang, Junyao; Benzine, Tiffany; Janssen, Harry L.A.; Khalili, Mandana; Lisker-Melman, Mauricio; Fontana, Robert J.; Belle, Steven H.; Fried, Michael W.

In: Open Forum Infectious Diseases, Vol. 6, No. 5, 01.05.2019.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Prevalence and impact of hepatitis E virus infection among persons with chronic hepatitis B living in the US and Canada

AU - McGivern, David R.

AU - Lin, Hsing Hua S.

AU - Wang, Junyao

AU - Benzine, Tiffany

AU - Janssen, Harry L.A.

AU - Khalili, Mandana

AU - Lisker-Melman, Mauricio

AU - Fontana, Robert J.

AU - Belle, Steven H.

AU - Fried, Michael W.

N1 - Funding Information: Financial support. This work was supported by the National Institute of Diabetes and Digestive and Kidney Disease grant U01 DK082867 to Dr Michael W. Fried and U01 DK082864 to Dr Steven H. Belle as an ancillary study of the Hepatitis B Research Network. Publisher Copyright: © 2019 Oxford University Press. All rights reserved.

PY - 2019/5/1

Y1 - 2019/5/1

N2 - 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.

AB - 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.

KW - Acute hepatitis

KW - Alanine aminotransferase

KW - Flare

KW - HBV

KW - HEV

UR - http://www.scopus.com/inward/record.url?scp=85067172337&partnerID=8YFLogxK

U2 - 10.1093/ofid/ofz175

DO - 10.1093/ofid/ofz175

M3 - Article

C2 - 31139669

AN - SCOPUS:85067172337

VL - 6

JO - Open Forum Infectious Diseases

JF - Open Forum Infectious Diseases

SN - 2328-8957

IS - 5

ER -

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

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