Increased HEV seroprevalence in patients with autoimmune hepatitis
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Increased HEV seroprevalence in patients with autoimmune hepatitis. / Pischke, Sven; Gisa, Anett; Suneetha, Pothakamuri Venkata; Wiegand, Steffen Björn; Taubert, Richard; Schlue, Jerome; Wursthorn, Karsten; Bantel, Heike; Raupach, Regina; Bremer, Birgit; Zacher, Behrend Johann; Schmidt, Reinhold Ernst; Manns, Michael Peter; Rifai, Kinan; Witte, Torsten; Wedemeyer, Heiner.
in: PLOS ONE, Jahrgang 9, Nr. 1, 01.01.2014, S. e85330.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Increased HEV seroprevalence in patients with autoimmune hepatitis
AU - Pischke, Sven
AU - Gisa, Anett
AU - Suneetha, Pothakamuri Venkata
AU - Wiegand, Steffen Björn
AU - Taubert, Richard
AU - Schlue, Jerome
AU - Wursthorn, Karsten
AU - Bantel, Heike
AU - Raupach, Regina
AU - Bremer, Birgit
AU - Zacher, Behrend Johann
AU - Schmidt, Reinhold Ernst
AU - Manns, Michael Peter
AU - Rifai, Kinan
AU - Witte, Torsten
AU - Wedemeyer, Heiner
PY - 2014/1/1
Y1 - 2014/1/1
N2 - 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.
AB - 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.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Arthritis, Rheumatoid
KW - Case-Control Studies
KW - Coinfection
KW - Female
KW - Hepatitis Antibodies
KW - Hepatitis B
KW - Hepatitis C
KW - Hepatitis E
KW - Hepatitis E virus
KW - Hepatitis, Autoimmune
KW - Hepatitis, Chronic
KW - Humans
KW - Immunocompromised Host
KW - Male
KW - Middle Aged
KW - RNA, Viral
KW - Seroepidemiologic Studies
KW - T-Lymphocytes
U2 - 10.1371/journal.pone.0085330
DO - 10.1371/journal.pone.0085330
M3 - SCORING: Journal article
C2 - 24465537
VL - 9
SP - e85330
JO - PLOS ONE
JF - PLOS ONE
SN - 1932-6203
IS - 1
ER -