Acute and Chronic Hepatitis E Virus Infection in HIV-Infected United States Women

Exposure to hepatitis E virus (HEV) is common in the United States (US) but there are few data on prevalence of HEV/HIV co-infection in US populations. 

We tested 2,919 plasma samples collected from HIV-infected (HIV+) women and men enrolled in US cohort studies for HEV viremia using a high-throughput nucleic acid testing (NAT) platform. NAT+ samples were confirmed by real-time polymerase chain reaction (PCR). Samples were selected for testing primarily on the basis of biomarkers of liver disease and immune suppression. 

Prevalence of HEV viremia was 3/2,606 and 0/313 in tested plasma samples collected from HIV+ women and men, respectively. 

All HEV isolates were genotype 3a. Based on follow-up testing of stored samples, one woman had chronic HEV infection for >4 years while 2 women had acute HEV detectable at only a single study visit.

CONCLUSION:

To our knowledge this is the first reported case of chronic HEV infection in an HIV⁺ US individual. We also confirm that chronic HEV infection can persist despite a CD4+ count >200 cells/mm³ . These data suggest that HEV infection is rare in the HIV+ US population.

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By:   Kuniholm MH1, Ong E2, Hogema BM3, Koppelman M3, Anastos K1,4, Peters MG5, Seaberg EC6, Chen Y7, Nelson KE6, Linnen JM2.

• 1Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
• 2Hologic, Inc., San Diego, CA, USA.
• 3Sanquin Research and Diagnostics, Departments of Virology, Blood-borne Infections and the National Screening Laboratory, Amsterdam, the Netherlands.
• 4Department of Medicine, Montefiore Medical Center, Bronx, NY, USA.
• 5Department of Medicine, University of California, San Francisco, CA, USA.
• 6Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
• 7Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA, USA. 

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