Impact of hepatitis E virus seropositivity on chronic liver disease in cancer patients with hepatitis C virus infection

Andreas Kyvernitakis; Mahnaz Taremi; Boris Blechacz; Jessica Hwang; Ying Jiang; Parag Mahale; Harrys A Torres

doi:10.1111/hepr.12460

Impact of hepatitis E virus seropositivity on chronic liver disease in cancer patients with hepatitis C virus infection

Hepatol Res. 2015 Nov;45(11):1146-51. doi: 10.1111/hepr.12460. Epub 2015 Jan 6.

Authors

Andreas Kyvernitakis¹, Mahnaz Taremi¹, Boris Blechacz², Jessica Hwang³, Ying Jiang¹, Parag Mahale¹, Harrys A Torres¹

Affiliations

¹ Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
² Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
³ Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

PMID: 25488194
DOI: 10.1111/hepr.12460

Abstract

Aim: Immunocompromised patients can develop chronic hepatitis E virus (HEV) infection and progress to cirrhosis. Hepatitis C virus (HCV)-infected cancer patients who have received chemotherapeutic agents experience accelerated liver fibrosis progression. Our aim was to investigate the prevalence and impact of HEV seropositivity on liver-related outcomes in HCV-infected cancer patients.

Methods: As part of a prospective study of HCV-infected cancer patients conducted at our center, we investigate the characteristics associated with progression of their liver disease.

Results: Of the 115 patients tested, 13 (11%) were positive for HEV immunoglobulin G. HEV seropositivity was associated with advanced age (P = 0.004), race (P = 0.02), place of birth outside the USA (P = 0.021), cirrhosis (P = 0.027), history of reused needles/syringes during massive vaccination campaigns (P = 0.015) and coronary artery disease (P = 0.039). Overall, 47 (41%) of the patients had cirrhosis. Factors independently associated with cirrhosis were male sex (odds ratio [OR], 2.8; P = 0.028) and HEV seropositivity (OR, 4.1; P = 0.032).

Conclusion: HEV seropositivity is present in 11% of HCV-infected cancer patients and seems to be associated with cirrhosis. Our results suggest that HEV screening should be implemented in HCV-infected patients with cancer.

Keywords: cancer; cirrhosis; hepatitis C virus; hepatitis E virus; immunocompromised.