Journal Article10.1111/LIV.14332
Higher seroprevalence of hepatitis E virus in autoimmune hepatitis: Role of false‐positive antibodies
Laura-Patricia Llovet,Jordi Gratacós-Ginès,Oswaldo Ortiz,Sergio Rodríguez-Tajes,Sabela Lens,Enric Reverter,Estibaliz Ruiz-Ortiz,Josep Costa,Odette Viñas,Xavier Forns,Albert Parés,María-Carlota Londoño +11 more
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TL;DR: This work aimed to assess the prevalence of positive anti‐HEV IgM and IgG, and HEV‐RNA in a cohort of patients with AIH, to determine the impact of positive HEV serology on patient outcome, and to evaluate the role of hypergammaglobulinemia and positive autoantibodies in the presence of positiveAnti-HEv serology.
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Abstract: Background and aims Recent studies have found an increase in the seroprevalence of hepatitis E virus (HEV) infection in patients with autoimmune hepatitis (AIH). We aimed to assess the prevalence of positive anti-HEV IgM and IgG, and HEV-RNA in a cohort of patients with AIH, to determine the impact of positive HEV serology on patient outcome, and to evaluate the role of hypergammaglobulinemia and positive autoantibodies in the presence of positive anti-HEV serology. Methods One hundred and five patients tested for HEV infection between 2014 and 2018 were included in the study: 50 with chronic AIH (more than 1 year on treatment), and 55 with an acute hepatitis (30 patients with acute AIH and 25 with non-AIH). Results Seroprevalence of HEV was higher in patients with acute AIH (17% vs 10% in patients with chronic AIH and 8% in patients with non-AIH). Patients with acute AIH and positive anti-HEV IgG were older (58 vs 40; P = .006), had higher IgG levels (27 g/dL vs 13 g/dL; P = .03) and antismooth muscle antibodies (ASMA) titres (1:160 vs 1:80; P = .045), and were more likely to have another autoimmune disease (60% vs 16%; P = .03). At the time of HEV testing, anti-HEV IgG positive patients had significantly higher serum IgG levels (17 g/L vs 11 g/L; P = .009), ANA (1:160 vs 1:60; P = .026) and ASMA titres (1:80 vs 1:40; P = .021). Conclusion Seroprevalence of HEV in patients with AIH in Catalonia does not differ from that of the general population. The higher HEV seroprevalence in patients with acute AIH with higher levels of gammaglobulins and high antibody titres suggest the presence of cross-reactivity between HEV and liver antigens.
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Approach to the patient with acute severe autoimmune hepatitis.
Mussarat N. Rahim,Rosa Miquel,Michael A. Heneghan +2 more
- 01 Dec 2020
TL;DR: A structured practical approach for diagnosing and managing this unique group of patients with acute severe autoimmune hepatitis, which is associated with varied clinical presentations and natural history and somewhat unpredictable treatment responses.
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Clinical Outcomes and Prevalence of Hepatitis E Virus (HEV) Among Non-A-C Hepatitis Patients in Egypt.
Ibrahim M Sayed,Mohamed A El-Mokhtar,Mahmoud A. Mahmoud,Amal A. Elkhawaga,Shereen S. Gaber,Nermien H. Seddek,Lobna Abdel-Wahid,Ahmed M Ashmawy,Enas Ahmed Reda Alkareemy +8 more
TL;DR: In this article, the authors used RT-qPCR to detect the viral load and sequencing analysis was carried out to determine the genotype of the detected viruses, and a phylogenetic tree was constructed to evaluate the genetic relatedness between the isolates.
Immune disorders and rheumatologic manifestations of viral hepatitis.
TL;DR: In this paper, the association between autoimmune liver diseases and hepatotropic virus infection was studied, and the results of treatment of these associated diseases with antiviral drugs were evaluated using clinical data.
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Incidence of Hepatitis E Infection in American Patients With Suspected Drug-Induced Liver Injury Is Low and Declining: The DILIN Prospective Study
Robert J. Fontana,Ronald E. Engle,Paul H. Hayashi,Jiezhun Gu,David E. Kleiner,H Nguyen,Huiman X. Barnhart,Jay H. Hoofnagle,Patrizia Farci +8 more
TL;DR: The results suggest that acute HEV infection is usually subclinical and was much more frequent in this cohort before 2004, and Clinicians should consider testing for unsuspected acuteHEV infection in older adult patients with acute hepatocellular DILI and jaundice.
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Significance of Anti-Nuclear Antibodies and Cryoglobulins in Patients with Acute and Chronic HEV Infection.
Thomas Horvatits,Julian Schulze zur Wiesch,Susanne Polywka,Gustav Buescher,Marc Lütgehetmann,Elaine Hussey,Karoline Horvatits,Sven Peine,Friedrich Haag,Marylyn M. Addo,Ansgar W. Lohse,Christina Weiler-Normann,Sven Pischke +12 more
TL;DR: In line with findings on HBV and HCV infections, detection of ANAs and cryoglobulins are frequently observed in association with HEV infections.
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