Z Gastroenterol 2015; 53 - P75
DOI: 10.1055/s-0035-1551763

Seroprevalence of Hepatitis E Virus in patients with Autoimmune Hepatitis

M Eder 1, S Beinhardt 1, R Strassl 1, A Stättermayer 1, C Freissmuth 1, K Kozbial 1, H Holzmann 1, P Ferenci 1, M Trauner 1, H Hofer 1
  • 1Medizinische Universität Wien, Wien, Austria

Background and Aims:

Incidence of autochthonous hepatitis E virus (HEV) infection is reported to increase in Europe and evolution of chronic hepatitis E has been shown in patients receiving immunosuppressive treatment after solid organ transplantation. HEV infection may mimic autoimmune hepatitis or disease flares during immunosuppressive treatment. Aim of the present study was to investigate the frequency of HEV infection in patients with AIH.

Methods:

Sera from seventy two consecutive patients with AIH (female: 55 [76.4%], age: 42.2 ± 17.5 years [mean ± SD]) in a tertiary referral center were retrospectively analyzed at baseline and during treatment. All patients were scored as probable or definite AIH according to the simplified and/or revised scoring system of the IAIHG; prevalence of anti-HEV-antibodies (Beijing Wantai Biological Pharmacy Enterprises Co., Ltd.) and HEV RNA was determined.

Results:

19 (26.4%) patients tested positive for HEV-IgG antibodies, which was more than twice as high as the previously reported sero-prevalence in healthy Austrian individuals (12.4%). No patient tested positive for HEV-RNA. Seropositive patients were older (51 ± 12 vs. 39 ± 18 years, [means ± SD], p < 0.01) but did not differ significantly in AST levels (14.6[1.3 – 121.5] vs. 8.6[0.7 – 84.3], xULN, median[range]), ALT levels (20.1[1.6 – 62.7] vs. 11[0.8 – 75.7], xULN, median[range]), bilirubin (1.8[0 – 32] vs. 1.9[0 – 58], mg/dl, median[range]) and IgG-levels (1.3[0.7 – 2.7] vs.1.3[0.6 – 3.8], xULN, median[range]). Seropositivity did not have an effect on treatment response after 6 or 12 months of immunosuppressive treatment, respectively.

Conclusions:

Seroprevalence of HEV-IgG was found to be high in our cohort with AIH patients suggestive that HEV infection might be a possible trigger for development of AIH. Testing for HEV RNA is advisable in patients examined for AIH or not responding to immunosuppressive treatment.