Seroprevalence and risk factors of hepatitis E virus infection in cancer patients in eastern China

Objectives: Hepatitis E virus (HEV) is a single-stranded RNA virus infecting a variety of animals and humans. Little is known of HEV infection among cancer patients in China. This study provides new epidemiological data for the prevalence of HEV co-infection in cancer patients, indicating that HEV infection is common in this group. Methods: A total of 950 cancer patients and 950 control volunteers from Shandong Province, eastern China, were recruited to participate in this investigation. Blood samples from patients and controls were examined for anti-HEV IgG and IgM antibodies using ELISAs. Results: The overall seroprevalence of IgG and IgM antibodies to HEV was significantly higher in cancer patients (247/950, 26.0%) than in controls (123/950,13.0%) (p < 0.001). In cancer patients, 22.7% of serum samples were anti-HEV IgG-positive, and in control subjects, 11.0% were anti-HEV IgG-positive (p < 0.001). For IgM antibodies, seroprevalence was 4.2% in cancer patients (n = 40) and 2.1% in controls (n = 20)(p = 0.009). The seroprevalence of HEV was higher in cancer patients who had dogs in their home (31.7%) when compared to other cancer patients. The highest seroprevalence of HEV infection was found in leukemia patients (32.3%), followed by liver cancer patients (31.1%); the lowest HEV seroprevalence was detected in patients with gastric cancer (18.9%). Conclusions: This investigation revealed that the seroprevalence of HEV was significantly higher in cancer patients than in controls in eastern China. Therefore, cancer patients are a high-risk population and should be kept away from sources of HEV infection. (C) 2018 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.