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...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier España
2021-11-01
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| Series: | Clinics |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100332&tlng=en |
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| author | Patricia Momoyo Yoshimura Zitelli Michele Gomes-Gouvêa Daniel F. Mazo Julio da Motta Singer Claudia P.M.S. Oliveira Alberto Queiroz Farias João Renato Pinho Ryan Yukimatsu Tanigawa Venâncio Avancini Ferreira Alves Flair José Carrilho Mário Guimarães Pessoa |
| author_facet | Patricia Momoyo Yoshimura Zitelli Michele Gomes-Gouvêa Daniel F. Mazo Julio da Motta Singer Claudia P.M.S. Oliveira Alberto Queiroz Farias João Renato Pinho Ryan Yukimatsu Tanigawa Venâncio Avancini Ferreira Alves Flair José Carrilho Mário Guimarães Pessoa |
| author_sort | Patricia Momoyo Yoshimura Zitelli |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-12T09:59:13Z |
| format | Article |
| id | doaj.art-f8580338b6384dc5a540b3193d1f98bf |
| institution | Directory Open Access Journal |
| issn | 1980-5322 |
| language | English |
| last_indexed | 2024-04-12T09:59:13Z |
| publishDate | 2021-11-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-f8580338b6384dc5a540b3193d1f98bf2022-12-22T03:37:37ZengElsevier EspañaClinics1980-53222021-11-017610.6061/clinics/2021/e3270Hepatitis E virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis C virus infectionPatricia Momoyo Yoshimura Zitellihttps://orcid.org/0000-0002-2444-7937Michele Gomes-Gouvêahttps://orcid.org/0000-0001-5932-2360Daniel F. Mazohttps://orcid.org/0000-0002-2164-2630Julio da Motta Singerhttps://orcid.org/0000-0001-6515-9643Claudia P.M.S. Oliveirahttps://orcid.org/0000-0002-2848-417XAlberto Queiroz Fariashttps://orcid.org/0000-0002-5572-663XJoão Renato Pinhohttps://orcid.org/0000-0003-3999-0489Ryan Yukimatsu Tanigawahttps://orcid.org/0000-0003-2357-558XVenâncio Avancini Ferreira Alveshttps://orcid.org/0000-0001-5285-4460Flair José Carrilhohttps://orcid.org/0000-0002-7682-3105Mário Guimarães Pessoahttps://orcid.org/0000-0002-0942-7348OBJECTIVES: 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100332&tlng=enHepatitis EHepatitis C, ChronicDiabetes MellitusLiver Cirrhosis |
| spellingShingle | Patricia Momoyo Yoshimura Zitelli Michele Gomes-Gouvêa Daniel F. Mazo Julio da Motta Singer Claudia P.M.S. Oliveira Alberto Queiroz Farias João Renato Pinho Ryan Yukimatsu Tanigawa Venâncio Avancini Ferreira Alves Flair José Carrilho Mário Guimarães Pessoa Hepatitis E virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis C virus infection Clinics Hepatitis E Hepatitis C, Chronic Diabetes Mellitus Liver Cirrhosis |
| 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 | Hepatitis E Hepatitis C, Chronic Diabetes Mellitus Liver Cirrhosis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100332&tlng=en |
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