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. 2014 Jan 21;9(1):e85330.
doi: 10.1371/journal.pone.0085330. eCollection 2014.

Increased HEV seroprevalence in patients with autoimmune hepatitis

Sven Pischke  1 , Anett Gisa  1 , Pothakamuri Venkata Suneetha  1 , Steffen Björn Wiegand  1 , Richard Taubert  1 , Jerome Schlue  2 , Karsten Wursthorn  1 , Heike Bantel  1 , Regina Raupach  1 , Birgit Bremer  1 , Behrend Johann Zacher  1 , Reinhold Ernst Schmidt  3 , Michael Peter Manns  1 , Kinan Rifai  1 , Torsten Witte  3 , Heiner Wedemeyer  1
Affiliations

Increased HEV seroprevalence in patients with autoimmune hepatitis

Sven Pischke et al. PLoS One. .

Abstract

Background: Hepatitis E virus (HEV) infection takes a clinically silent, self-limited course in the far majority of cases. Chronic hepatitis E has been reported in some cohorts of immunocompromised individuals. The role of HEV infections in patients with autoimmune hepatitis (AIH) is unknown.

Methods: 969 individuals were tested for anti-HEV antibodies (MP-diagnostics) including 208 patients with AIH, 537 healthy controls, 114 patients with another autoimmune disease, rheumatoid arthritis (RA), and 109 patients with chronic HCV- or HBV-infection (HBV/HCV). Patients with AIH, RA and HBV/HCV were tested for HEV RNA. HEV-specific proliferative T cell responses were investigated using CFSE staining and in vitro stimulation of PBMC with overlapping HEV peptides.

Results: HEV-antibodies tested more frequently positive in patients with AIH (n = 16; 7.7%) than in healthy controls (n = 11; 2.0%; p = 0.0002), patients with RA (n = 4; 3.5%; p = 0.13) or patients with HBV/HCV infection (n = 2; 2.8%; p = 0.03). HEV-specific T cell responses could be detected in all anti-HEV-positive AIH patients. One AIH patient receiving immunosuppression with cyclosporin and prednisolone and elevated ALT levels had acute hepatitis E but HEV viremia resolved after reducing immunosuppressive medication. None of the RA or HBV/HCV patients tested HEV RNA positive.

Conclusions: Patients with autoimmune hepatitis but not RA or HBV/HCV patients are more likely to test anti-HEV positive. HEV infection should been ruled out before the diagnosis of AIH is made. Testing for HEV RNA is also recommended in AIH patients not responding to immunosuppressive therapy.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Seroprevalence rate of HEV specific antibodies in healthy controls, patients with chronic HBV- or HCV-infection and patients with autoimmune hepatitis.
Figure 2
Figure 2. Histology of an autoimmune hepatitis patient with acute HEV infection.
(H.E. stain, original magnification 200×).
Figure 3
Figure 3. HEV specific T-cell responses in AIH patients (anti-HEV IgG positive).
See this image and copyright information in PMC

References

    1. Manns MP, Strassburg CP (2001) Gastroenterology 120: 1502–17.. - PubMed
    1. Manns MP (1993) Intervirology 35: 108–15.. - PubMed
    1. Manns MP (1997) J Viral Hepat 4 Suppl 1: 7–10.. - PubMed
    1. Vento S, Cainelli F (2004) Autoimmun Rev 3: 61–9.. - PubMed
    1. Wedemeyer H, Pischke S, Manns MP (2012) Gastroenterology 142: 1388–1397 e1.. - PubMed

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