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Hepatitis E virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis C virus infection

OBJECTIVES: Co-infection with hepatitis A or B viruses may aggravate liver injury in patients infected with hepatitis C virus (HCV). However, few studies have assessed co-infection with hepatitis E virus (HEV) and HCV. Therefore, this study aimed to assess the prevalence and impact of HEV infection...

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Autores principales: Zitelli, Patricia Momoyo Yoshimura, Gomes-Gouvêa, Michele, Mazo, Daniel F., Singer, Julio da Motta, Oliveira, Claudia P.M.S., Farias, Alberto Queiroz, Pinho, João Renato, Tanigawa, Ryan Yukimatsu, Alves, Venâncio Avancini Ferreira, Carrilho, Flair José, Pessoa, Mário Guimarães
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Faculdade de Medicina / USP 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8595601/
https://www.ncbi.nlm.nih.gov/pubmed/34852140
http://dx.doi.org/10.6061/clinics/2021/e3270
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author Zitelli, Patricia Momoyo Yoshimura
Gomes-Gouvêa, Michele
Mazo, Daniel F.
Singer, Julio da Motta
Oliveira, Claudia P.M.S.
Farias, Alberto Queiroz
Pinho, João Renato
Tanigawa, Ryan Yukimatsu
Alves, Venâncio Avancini Ferreira
Carrilho, Flair José
Pessoa, Mário Guimarães
author_facet Zitelli, Patricia Momoyo Yoshimura
Gomes-Gouvêa, Michele
Mazo, Daniel F.
Singer, Julio da Motta
Oliveira, Claudia P.M.S.
Farias, Alberto Queiroz
Pinho, João Renato
Tanigawa, Ryan Yukimatsu
Alves, Venâncio Avancini Ferreira
Carrilho, Flair José
Pessoa, Mário Guimarães
author_sort Zitelli, Patricia Momoyo Yoshimura
collection PubMed
description OBJECTIVES: Co-infection with hepatitis A or B viruses may aggravate liver injury in patients infected with hepatitis C virus (HCV). However, few studies have assessed co-infection with hepatitis E virus (HEV) and HCV. Therefore, this study aimed to assess the prevalence and impact of HEV infection among Brazilian patients with chronic HCV infection. METHODS: This observational study included adult patients with chronic HCV infection who were naive to antiviral therapy from January 2013 to March 2016. A total of 181 patients were enrolled, and HEV serology and PCR were performed for all patients. RESULTS: Seropositivity for anti-HEV IgG was detected in 22 (12.0%) patients and anti-HEV immunoglobulin M in 3 (1.6%). HEV RNA showed inconclusive results in nine (4.9%) patients and was undetectable in the remaining patients. HEV serology positive patients had more severe liver disease, characterized by liver fibrosis ≥3 versus ≤2 (p<0.001), Aspartate Aminotransferase-to-Platelet Ratio Index of ≥1.45 (p=0.003), and Fibrosis-4 score of ≥3.25 (p=0.001). Additionally, the odds of HEV-positive patients developing diabetes mellitus were 3.65 (95% CI 1.40-9.52) times the corresponding odds of HEV-negative patients. A case-control-based histological analysis (n=11 HEV-HCV-positive patients and n=22 HCV-positive patients) showed no significant differences between the groups. CONCLUSIONS: This prevalence is higher than that reported in previous studies of the general population in Brazil. Thus, HEV infection may influence the severity of liver disease and may represent an additional risk of developing diabetes mellitus in patients with HCV infection.
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spelling pubmed-85956012021-11-19 Hepatitis E virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis C virus infection Zitelli, Patricia Momoyo Yoshimura Gomes-Gouvêa, Michele Mazo, Daniel F. Singer, Julio da Motta Oliveira, Claudia P.M.S. Farias, Alberto Queiroz Pinho, João Renato Tanigawa, Ryan Yukimatsu Alves, Venâncio Avancini Ferreira Carrilho, Flair José Pessoa, Mário Guimarães Clinics (Sao Paulo) Original Article OBJECTIVES: Co-infection with hepatitis A or B viruses may aggravate liver injury in patients infected with hepatitis C virus (HCV). However, few studies have assessed co-infection with hepatitis E virus (HEV) and HCV. Therefore, this study aimed to assess the prevalence and impact of HEV infection among Brazilian patients with chronic HCV infection. METHODS: This observational study included adult patients with chronic HCV infection who were naive to antiviral therapy from January 2013 to March 2016. A total of 181 patients were enrolled, and HEV serology and PCR were performed for all patients. RESULTS: Seropositivity for anti-HEV IgG was detected in 22 (12.0%) patients and anti-HEV immunoglobulin M in 3 (1.6%). HEV RNA showed inconclusive results in nine (4.9%) patients and was undetectable in the remaining patients. HEV serology positive patients had more severe liver disease, characterized by liver fibrosis ≥3 versus ≤2 (p<0.001), Aspartate Aminotransferase-to-Platelet Ratio Index of ≥1.45 (p=0.003), and Fibrosis-4 score of ≥3.25 (p=0.001). Additionally, the odds of HEV-positive patients developing diabetes mellitus were 3.65 (95% CI 1.40-9.52) times the corresponding odds of HEV-negative patients. A case-control-based histological analysis (n=11 HEV-HCV-positive patients and n=22 HCV-positive patients) showed no significant differences between the groups. CONCLUSIONS: This prevalence is higher than that reported in previous studies of the general population in Brazil. Thus, HEV infection may influence the severity of liver disease and may represent an additional risk of developing diabetes mellitus in patients with HCV infection. Faculdade de Medicina / USP 2021-11-17 2021 /pmc/articles/PMC8595601/ /pubmed/34852140 http://dx.doi.org/10.6061/clinics/2021/e3270 Text en Copyright © 2021 CLINICS https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.
spellingShingle Original Article
Zitelli, Patricia Momoyo Yoshimura
Gomes-Gouvêa, Michele
Mazo, Daniel F.
Singer, Julio da Motta
Oliveira, Claudia P.M.S.
Farias, Alberto Queiroz
Pinho, João Renato
Tanigawa, Ryan Yukimatsu
Alves, Venâncio Avancini Ferreira
Carrilho, Flair José
Pessoa, Mário Guimarães
Hepatitis E virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis C virus infection
title Hepatitis E virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis C virus infection
title_full Hepatitis E virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis C virus infection
title_fullStr Hepatitis E virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis C virus infection
title_full_unstemmed Hepatitis E virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis C virus infection
title_short Hepatitis E virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis C virus infection
title_sort hepatitis e virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis c virus infection
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8595601/
https://www.ncbi.nlm.nih.gov/pubmed/34852140
http://dx.doi.org/10.6061/clinics/2021/e3270
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