Hepatitis E virus (HEV) seropositivity may confer an increased risk of liver fibrosis in immunosuppressed individuals. We studied this effect in HIV-infected individuals in Nepal, a country hyperendemic for HEV.
We prospectively evaluated 200 HIV-positive individuals. Serum samples were tested for components of fibrosis scores and cytokeratin-18.
Of 200 patients, 43% were HEV-immunoglobulin G+. The mean fibrosis-4 score was 8.02 in the HEV-positive and 1.17 in the HEV-negative group (P<0.001). The mean nonalcoholic fatty liver disease score was 2.12 in the HEV-positive and −2.53 in the HEV-negative group (P=0.02). The mean aminotransferase-platelet ratio index score was 0.37 in the HEV-positive and 0.38 in the HEV-negative group (P=0.9). The mean cytokeratin-18 levels were 119.9 in the HEV-positive group and 158.6 in the HEV-negative group (P=0.08).
We found higher fibrosis-4 and nonalcoholic fatty liver disease scores in HEV-HIV-positive individuals, suggesting an increased liver fibrosis profile in this group. Further studies using liver stiffness measurements should be carried out.
aDepartment of Medicine, University of Minnesota
bDepartment of Medicine, Gastroenterology and Hepatology, Hennepin County Medical Center
cAnalytic Center of Excellence, Hennepin County Medical Center, Minneapolis, Minnesota, USA
dDepartment of Hepatology, Liver Foundation Nepal
eDepartment of Microbiology, Kathmandu College of Science and Technology
fDepartment of Virology, Central Diagnostic Laboratory and Research Centre, Kathmandu, Nepal
gDepartment of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands
Correspondence to Jose D. Debes, MD, MS, Department of Medicine, University of Minnesota, 420 Delaware Street SE, MMC 250, Minneapolis, Minnesota 55455, USA Tel: +1 612 624 6353; fax: +1 612 625 4410; e-mail: firstname.lastname@example.org
Received September 8, 2018
Accepted October 22, 2018