Hepatitis E prevalence among HIV infected patients with elevated liver enzymes in the Netherlands

Background: In recent years chronic hepatitis E virus (HEV) infections have been reported in immunosuppressed patients, including HIV-positive patients with low CD4 cell counts. Because of delayed anti-HEV seroconversion in patients with CD4 cell count <200 cells/ml it is difficult to draw firm conclusions on HEV-seroprevalence in a population of HIV positive patients. Objectives: To determine the HEV seroprevalence in a population of HIV infected patients. Study design: We retrospectively analysed the HEV prevalence in a population of 256 HIV infected patients with liver enzyme elevations (LEEs), using HEV specific antibody testing and HEV-RNA detection. Results: Within this cohort we observed a HEV-seroprevalence of 11.7%, without any anti-HEV IgM positive or HEV-RNA positive cases. HEV seropositivity was equally prevalent among different CD4(+) cell count groups. Conclusion: Although HIV infected patients in the Netherlands are at risk of acquiring HEV, the number of acute infections is low and no chronic cases were found. (C) 2014 Elsevier B.V. All rights reserved.