December 02, 2018
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Hepatitis E prevalent among patients with HIV in Central African Republic

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Hepatitis E is prevalent in patients living with HIV in Bangui, the capital city of the Central African Republic, researchers reported.

According to their findings, 7.5% of patients with HIV had test results indicative of acute hepatitis E virus (HEV) infection and 68% had anti-HEV antibodies. The results, they said, “should be taken into account in identifying the risk factors” of people living with HIV for HEV infection.

Writing in Open Forum Infectious Diseases, Narcisse Patrice Komas, PharmD, PhD, and colleagues from the Pasteur Institute in Bangui noted that HEV, a waterborne virus, causes acute hepatitis in both immunocompromised and immunocompetent. The virus is one of the main agents of enterotransmissible viral hepatitis and is most often self-limited and asymptomatic, they added. According to the study, the Central African Republic is one of the few countries in the world that is endemic for HEV and HIV, with HIV affecting 4.9% of adults aged 15 to 49 years.

“As cases of chronic HEV infection have been reported in immunocompromised individuals, HEV may be a significant threat to the survival of people living with HIV,” Komas and colleagues wrote. “Immune system failure due to HIV infection exposes the body to attack by other infectious agents that are controlled by a healthy immune system. Few studies have been done on the prevalence of HEV infection among [people living with HIV] in resource-poor countries [such] as the Central African Republic, although several outbreaks have been reported in Bangui, the capital.”

Komas and colleagues conducted a cross-sectional study between April and September of 2015 to characterize the epidemiology of HEV in people living with HIV in the city. Results were based on questionnaire answers and collected blood samples.

The study included 200 people living with HIV, 7.5% (n = 15) of whom had IgM, the immunoglobulin that characterizes acute HEV infection, Komas and colleagues reported. This included 8.9% of women and 2.2% of males. Results also showed that the overall seroprevalence of HEV IgG was 68%, including 48% in women and 70.4% men, indicating that men are significantly more exposed to the virus, the researchers said.

“It might be possible to monitor biochemical, biological and hematological parameters in [people living with HIV] by ensuring good therapeutic management of HEV and to extend the study of risk factors by isolating HEV from the stools of [people living with HIV] and including samples from their environment,” the authors concluded. “Our results should be taken into account in identifying the risk factors of [people living with HIV] for HEV infection. The sample size may have been too small, and further larger studies are required to confirm these results.” – by Caitlyn Stulpin

Disclosures: The authors report no relevant financial disclosures.