Prevalence of antibodies and RNA genome of hepatitis E virus in a cohort of French immunocompromised

J Clin Virol. 2012 Apr;53(4):346-9. doi: 10.1016/j.jcv.2012.01.001. Epub 2012 Jan 30.


Background: Recently, cases of chronic hepatitis E have been identified in immunocompromised patients.

Objectives: To evaluate the prevalence of anti-HEV IgG antibodies and the persistence of HEV-RNA in sera of immunocompromised patients with regular follow-up at Saint-Louis Hospital in Paris, France.

Study design: 307 samples collected from 261 HIV-infected patients and 46 kidney transplant (KT)-patients were retrospectively tested for the presence of the following hepatitis E virus (HEV) infection markers: anti-HEV IgM antibodies, anti-HEV IgG antibodies, anti-HEV IgG avidity index, and HEV-RNA.

Results: Anti-HEV IgG positive serology was found in 4 HIV-infected patients (1.5%) and 3 KT-patients (6.5%), leading to an overall seroprevalence of 2.3%. HEV-RNA detection was not observed among 55 HIV-patients at higher risk of chronic HEV (<200 CD4 cells/mm(3), elevated alanine aminotransferase (ALT) levels, and/or positive anti-HEV antibodies) and among 44 KT-patients. None of the seven patients had anti-HEV IgM antibodies, thereby excluding any acute infection. The IgG avidity index confirmed past HEV infection among tested patients.

Conclusions: The low seroprevalence observed in the Paris region does not warrant a systematic evaluation of HEV infection in immunocompromised patients. However, HEV infection must be examined as a possibility if unexplained increases in ALT should occur and after more common viral hepatitis infections are excluded.

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Genome, Viral
  • Hepatitis Antibodies / blood*
  • Hepatitis E / epidemiology*
  • Hepatitis E / virology
  • Hepatitis E virus / genetics
  • Hepatitis E virus / immunology*
  • Hepatitis E virus / isolation & purification
  • Hepatitis, Chronic
  • Humans
  • Immunocompromised Host*
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Male
  • Middle Aged
  • Paris / epidemiology
  • Prevalence
  • RNA, Viral / blood*
  • Urban Population


  • Hepatitis Antibodies
  • Immunoglobulin G
  • Immunoglobulin M
  • RNA, Viral