scholarly journals Significance of Anti-Nuclear Antibodies and Cryoglobulins in Patients with Acute and Chronic HEV Infection

Pathogens ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 755
Author(s):  
Thomas Horvatits ◽  
Julian Schulze zur Wiesch ◽  
Susanne Polywka ◽  
Gustav Buescher ◽  
Marc Lütgehetmann ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Acute Hepatitis ◽  
Blood Donors ◽  
Hepatitis E ◽  
Chronic Hepatitis B Virus ◽  
B Virus ◽  
Immunosuppressed Patients ◽  
Acute Hepatitis E ◽  
Immune Phenomena ◽  
Immunocompetent Patients

Background: Hepatitis E virus (HEV) has been associated with immunological phenomena. Their clinical significance, however, still needs to be clarified, that is, whether cryoglobulins or autoantibodies impact overt disease in HEV-infected individuals. To better understand, we analyzed these different immune phenomena in three cohorts, each representing different types of HEV infection. Methods: The cohorts included: (i) immunocompetent patients with acute hepatitis E, (ii) immunosuppressed patients with chronic hepatitis E, and (iii) individuals with asymptomatic HEV infection. Together, they consisted of 57 individuals and were studied retrospectively for the presence of anti-nuclear antibodies (ANAs), cryoglobulins, and serum total IgG. They were then compared with a control cohort of 17 untreated patients with chronic hepatitis B virus (HBV) infection or hepatitis C virus (HCV) infection. Results: Thirteen (23%) were immunocompetent patients with acute hepatitis E (median alanine aminotransferase (ALT) = 872 U/L), 15 (26%) were immunosuppressed patients with chronic hepatitis E (median ALT = 137 U/L), and 29 (51%) were blood donors with asymptomatic HEV infection (median ALT = 35 U/L). Overall, 24% tested positive for elevated ANA titers of >1:160, and 11% presented with a specific ANA pattern. ANA detection was not associated with the type of HEV infection, IgG levels, sex, or age. All individuals tested negative for anti-mitochondrial antibodies, anti-neutrophil cytoplasmic antibodies, liver-kidney microsomal antibodies, anti-myeloperoxidase-, and anti-proteinase-3 antibodies. Five patients (9%) tested positive for cryoglobulins. Notably, cryoglobulinemia was present in overt hepatitis E (Groups (i) and (ii); one acute and four chronic HEV infections), but was not present in any of the asymptomatic blood donors (p = 0.02). The frequency of cryoglobulins and elevated ANAs did not differ significantly between HEV and HBV/HCV patients. Conclusion: In line with findings on HBV and HCV infections, we frequently observed detection of ANAs (24%) and cryoglobulins (9%) in association with HEV infections. The presence of cryoglobulins was limited to patients with overt hepatitis E. We add to the findings on the immune phenomena of hepatitis E.

scholarly journals An Epidemiologic Investigation of a Case of Acute Hepatitis E

2015 ◽  
Vol 53 (11) ◽  
pp. 3547-3552 ◽  
Author(s):  
Souvik Sarkar ◽  
Elenita M. Rivera ◽  
Ronald E. Engle ◽  
Hanh T. Nguyen ◽  
Cathy A. Schechterly ◽  
...  
Keyword(s):  
Acute Hepatitis ◽  
Blood Donors ◽  
Hepatitis E ◽  
Transmission Risk ◽  
Genotype 3 ◽  
Modes Of Transmission ◽  
Parenteral Transmission ◽  
Potential Mode ◽  
Acute Hepatitis E ◽  
Animal Handlers

Hepatitis E virus (HEV) is considered a zoonotic infection in developed nations. A case of acute hepatitis E in a researcher following a scalpel injury while working on a pig prompted a seroepidemiologic study to identify potential modes of transmission and determine the seroprevalence of HEV among animal handlers at the institute. Sera from personnel (n= 64) in two animal facilities and age/sex-matched blood donors (n= 63) as controls were tested for IgG anti-HEV and, if positive, for IgM anti-HEV and HEV RNA. Sera and stool from pigs aged 6 to 12 weeks from the breeding farm and older pigs from animal facilities were tested similarly. The median age of personnel was 36 years, 74% were white, 56% were male, and 74% had direct exposure to pigs. The prevalence of anti-HEV was 3.1% among personnel compared to 3.2% among blood donors; none were positive for IgM anti-HEV or HEV RNA. IgG anti-HEV was detected in sera from 10% of pigs aged 6 to 8 weeks, 80% aged 10 weeks, 100% aged 12 weeks, and 76% aged >12 weeks. HEV RNA was detected in stool but not sera from three 12-week-old pigs. Sequencing revealed HEV genotype 3 with ∼10% difference between the patient and pig sequences. Parenteral transmission is a potential mode of acute HEV infection. The low and similar seroprevalence of anti-HEV between the at-risk group and age-matched blood donors suggests low transmission risk with universal precautions among animal handlers.

scholarly journals Risk factors for chronic hepatitis B virus infection among blood donors in Bangalore, India

2010 ◽  
Vol 20 (6) ◽  
pp. 414-420 ◽  
Author(s):  
L. Jagannathan ◽  
M. Chaturvedi ◽  
S. Mudaliar ◽  
T. Kamaladoss ◽  
M. Rice ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Hepatitis ◽  
Hepatitis B Virus ◽  
Virus Infection ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Blood Donors ◽  
Hepatitis B Virus Infection ◽  
Chronic Hepatitis B Virus ◽  
B Virus

scholarly journals Acute hepatitis E superinfection leading to chronic hepatitis B reactivation

2018 ◽  
pp. bcr-2017-223616 ◽  
Author(s):  
Aysha Aslam ◽  
Ammu Susheela ◽  
Sentia Iriana ◽  
Suzanne S Chan ◽  
Daryl Lau
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Acute Hepatitis ◽  
Chronic Hepatitis B ◽  
Hepatitis E ◽  
Hepatitis B Reactivation ◽  
Acute Hepatitis E

scholarly journals Hepatitis E: Disease in Humans

2020 ◽  
Author(s):  
Adriana Turculeanu
Keyword(s):  
Acute Hepatitis ◽  
Pregnant Women ◽  
Organ Transplant ◽  
The Elderly ◽  
Hepatitis E ◽  
Hematologic Malignancies ◽  
Hematological Diseases ◽  
The World ◽  
Acute Hepatitis E ◽  
Immunocompetent Patients

Hepatitis E virus (HEV) is one of the 7 viruses with mainly hepatic tropism. HEV determines 20 million new infections worldwide every year, 3.4 million acute hepatitis E and 44,000 deaths in 2015 (3.3% of the mortality due to viral hepatitis). Transmitted by the digestive tract mainly (fecal- orally, particularly by water infected with feces), the virus reaches the liver where it does not have a direct cytolytic effect, but immunological phenomena, especially cellular, activated by the replication of the virus in the hepatocytes. Clinically, over 95% of cases of HEV infection are asymptomatic and sel- limiting; in immunocompetent patients in tropics HEV can cause acute hepatitis with clinical features. On rare situations the infection can result in a severe, fulminant hepatitis with acute liver failure. In immunocompromised patients (organ transplant recipients, hematologic malignancies, HIV-infected) HEV may determine chronic hepatitis. In pregnant women or the elderly people or people with underlying liver disease HEV can cause fulminant forms which can become fatal (E.g.: 30% deaths among pregnant women in some parts of the world). Acute and chronic E hepatitis may be accompanied by extrahepatic manifestations: neurological, kidney, pancreatic, hematological diseases, autoimmune diseases with a pathogenesis not fully elucidated.

Sign in / Sign up

Export Citation Format

Share Document