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Hepatitis E Virus Infection in Patients with Chronic Inflammatory Bowel Disease Treated with Immunosuppressive Therapy

Background: Medical treatment of inflammatory bowel disease (IBD) has evolved significantly, and treatment with immunomodulators is recommended. These medications may alter the patient’s immune response and increase the risk of opportunistic infections. Our aim was to evaluate the prevalence and the...

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Autores principales: Kounis, Ilias, Renou, Christophe, Nahon, Stephane, Heluwaert, Frederic, Macaigne, Gilles, Amil, Morgane, Talom, Stephane, Lambare, Benedicte, Charpignon, Claire, Paupard, Thierry, Stetiu, Monica, Ripault, Marie Pierre, Yamaga, Armand, Ehrhard, Florent, Audemar, Franck, Ortiz Correro, Maria Carmen, Zanditenas, David, Skinazi, Florence, Agostini, Helene, Coilly, Audrey, Roque-Afonso, Anne Marie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9966788/
https://www.ncbi.nlm.nih.gov/pubmed/36839604
http://dx.doi.org/10.3390/pathogens12020332
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author Kounis, Ilias
Renou, Christophe
Nahon, Stephane
Heluwaert, Frederic
Macaigne, Gilles
Amil, Morgane
Talom, Stephane
Lambare, Benedicte
Charpignon, Claire
Paupard, Thierry
Stetiu, Monica
Ripault, Marie Pierre
Yamaga, Armand
Ehrhard, Florent
Audemar, Franck
Ortiz Correro, Maria Carmen
Zanditenas, David
Skinazi, Florence
Agostini, Helene
Coilly, Audrey
Roque-Afonso, Anne Marie
author_facet Kounis, Ilias
Renou, Christophe
Nahon, Stephane
Heluwaert, Frederic
Macaigne, Gilles
Amil, Morgane
Talom, Stephane
Lambare, Benedicte
Charpignon, Claire
Paupard, Thierry
Stetiu, Monica
Ripault, Marie Pierre
Yamaga, Armand
Ehrhard, Florent
Audemar, Franck
Ortiz Correro, Maria Carmen
Zanditenas, David
Skinazi, Florence
Agostini, Helene
Coilly, Audrey
Roque-Afonso, Anne Marie
author_sort Kounis, Ilias
collection PubMed
description Background: Medical treatment of inflammatory bowel disease (IBD) has evolved significantly, and treatment with immunomodulators is recommended. These medications may alter the patient’s immune response and increase the risk of opportunistic infections. Our aim was to evaluate the prevalence and the incidence of acute or chronic HEV infection in IBD patients under immunomodulatory treatment. Patients and Methods: We conducted a retrospective, multicenter, observational study between 2017 and 2018. IBD outpatients hospitalized for the infusion of immunomodulators were included in 16 French centers. During their daily hospitalization, blood samples were drawn for HEV serology (IgM and IgG) and HEV RNA detection. Results: A total of 488 patients were included, of which 327 (67%) patients had Crohn’s disease and 161 (33%) ulcerative colitis. HEV IgM was detected in 3 patients, but HEV RNA was undetectable in all patients. The HEV IgG seroprevalence rate was 14.2%. IgG-positive patients were older at sampling (p = 0.01) and IBD diagnosis (p = 0.03), had higher seafood consumption (p = 0.01) and higher doses of azathioprine (p = 0.03). Ileal and upper digestive tract involvement was more frequent in IgG-positive patients (p = 0.009), and ileocolic involvement was more frequent in IgG-negative patients (p = 0.01). Under multivariate analysis, age > 50 years [OR: 2.21 (1.26, to 3.85), p = 0.004] was associated with previous HEV infection. Conclusion: Systematic screening for HEV infection is not needed among IBD patients on immunomodulatory medications. However, in the event of abnormal liver test findings, HEV should be part of the classic diagnostic assessment.
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spelling pubmed-99667882023-02-26 Hepatitis E Virus Infection in Patients with Chronic Inflammatory Bowel Disease Treated with Immunosuppressive Therapy Kounis, Ilias Renou, Christophe Nahon, Stephane Heluwaert, Frederic Macaigne, Gilles Amil, Morgane Talom, Stephane Lambare, Benedicte Charpignon, Claire Paupard, Thierry Stetiu, Monica Ripault, Marie Pierre Yamaga, Armand Ehrhard, Florent Audemar, Franck Ortiz Correro, Maria Carmen Zanditenas, David Skinazi, Florence Agostini, Helene Coilly, Audrey Roque-Afonso, Anne Marie Pathogens Brief Report Background: Medical treatment of inflammatory bowel disease (IBD) has evolved significantly, and treatment with immunomodulators is recommended. These medications may alter the patient’s immune response and increase the risk of opportunistic infections. Our aim was to evaluate the prevalence and the incidence of acute or chronic HEV infection in IBD patients under immunomodulatory treatment. Patients and Methods: We conducted a retrospective, multicenter, observational study between 2017 and 2018. IBD outpatients hospitalized for the infusion of immunomodulators were included in 16 French centers. During their daily hospitalization, blood samples were drawn for HEV serology (IgM and IgG) and HEV RNA detection. Results: A total of 488 patients were included, of which 327 (67%) patients had Crohn’s disease and 161 (33%) ulcerative colitis. HEV IgM was detected in 3 patients, but HEV RNA was undetectable in all patients. The HEV IgG seroprevalence rate was 14.2%. IgG-positive patients were older at sampling (p = 0.01) and IBD diagnosis (p = 0.03), had higher seafood consumption (p = 0.01) and higher doses of azathioprine (p = 0.03). Ileal and upper digestive tract involvement was more frequent in IgG-positive patients (p = 0.009), and ileocolic involvement was more frequent in IgG-negative patients (p = 0.01). Under multivariate analysis, age > 50 years [OR: 2.21 (1.26, to 3.85), p = 0.004] was associated with previous HEV infection. Conclusion: Systematic screening for HEV infection is not needed among IBD patients on immunomodulatory medications. However, in the event of abnormal liver test findings, HEV should be part of the classic diagnostic assessment. MDPI 2023-02-15 /pmc/articles/PMC9966788/ /pubmed/36839604 http://dx.doi.org/10.3390/pathogens12020332 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Kounis, Ilias
Renou, Christophe
Nahon, Stephane
Heluwaert, Frederic
Macaigne, Gilles
Amil, Morgane
Talom, Stephane
Lambare, Benedicte
Charpignon, Claire
Paupard, Thierry
Stetiu, Monica
Ripault, Marie Pierre
Yamaga, Armand
Ehrhard, Florent
Audemar, Franck
Ortiz Correro, Maria Carmen
Zanditenas, David
Skinazi, Florence
Agostini, Helene
Coilly, Audrey
Roque-Afonso, Anne Marie
Hepatitis E Virus Infection in Patients with Chronic Inflammatory Bowel Disease Treated with Immunosuppressive Therapy
title Hepatitis E Virus Infection in Patients with Chronic Inflammatory Bowel Disease Treated with Immunosuppressive Therapy
title_full Hepatitis E Virus Infection in Patients with Chronic Inflammatory Bowel Disease Treated with Immunosuppressive Therapy
title_fullStr Hepatitis E Virus Infection in Patients with Chronic Inflammatory Bowel Disease Treated with Immunosuppressive Therapy
title_full_unstemmed Hepatitis E Virus Infection in Patients with Chronic Inflammatory Bowel Disease Treated with Immunosuppressive Therapy
title_short Hepatitis E Virus Infection in Patients with Chronic Inflammatory Bowel Disease Treated with Immunosuppressive Therapy
title_sort hepatitis e virus infection in patients with chronic inflammatory bowel disease treated with immunosuppressive therapy
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9966788/
https://www.ncbi.nlm.nih.gov/pubmed/36839604
http://dx.doi.org/10.3390/pathogens12020332
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