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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.
Details
1 Lineberger Comprehensive Cancer Center and Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
2 Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
3 Lineberger Comprehensive Cancer Center and Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
4 Toronto Centre for Liver Disease, University Health Network, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
5 Department of Medicine, University of California San Francisco, San Francisco, California
6 Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri
7 Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
8 UNC Liver Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina