Hepatitis E seroprevalence in recipients of renal transplants or haemodialysis in southwest England: a case-control study.

Abstract

Locally acquired HEV infection is increasingly recognized in developed countries. Anti-HEV IgG seroprevalence has been shown to be high in haemodialysis patients in a number of previous studies, employing assays of uncertain sensitivity. The aim of this study was to investigate anti-HEV IgG seroprevalence in recipients of haemodialysis and renal transplants compared to a control group using a validated, highly sensitive assay. Eighty-eight patients with functioning renal transplants and 76 receiving chronic haemodialysis were tested for HEV RNA and anti-HEV IgG and IgM. Six hundred seventy controls were tested for anti-HEV IgG. Anti-HEV IgG was positive in 28/76 (36.8%) of haemodialysis and 16/88 (18.2%) of transplant patients. HEV RNA was not found in any patient. 126/670 (18.8%) of control subjects were anti-HEV IgG positive. After adjusting for age and sex, there was a significantly higher anti-HEV IgG seroprevalence amongst haemodialysis patients compared to controls (OR = 1.97, 95% CI = 1.16-3.31, P = 0.01) or transplant recipients (OR = 2.63, 95% CI = 1.18-6.07, P = 0.02). Patients with a functioning transplant showed no difference in anti-HEV IgG seroprevalence compared to controls. The duration of haemodialysis or receipt of blood products were not significant risk factors for HEV IgG positivity. Patients receiving haemodialysis have a higher seroprevalence of anti-HEV IgG than both age- and sex-matched controls and a cohort of renal transplant patients. None of the haemodialysis patients had evidence of chronic infection. The reason haemodialysis patients have a high seroprevalence remains uncertain and merits further study.

• Authors: Alex Harrison, Linda Scobie, Claire Crossan, Rob Parry, Paul Johnston, Jon Stratton, Steve Dickinson, Vic Ellis, Jeremy G Hunter, Oliver R Prescott, Richie Madden, Nan X Lin, William E Henley, Richard P Bendall, Harry R Dalton
• Journal: Journal of medical virology (J Med Virol) Vol. 85 Issue 2 Pg. 266-71 (Feb 2013) ISSN: 1096-9071 [Electronic] United States
• PMID: 23169048 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Wiley Periodicals, Inc.

Chemical References

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

Topics

• Adult
• Aged
• Aged, 80 and over
• Case-Control Studies
• England (epidemiology)
• Female
• Hepatitis Antibodies (blood)
• Hepatitis E (epidemiology)
• Hepatitis E virus (genetics, immunology)
• Humans
• Immunoglobulin G (blood)
• Immunoglobulin M (blood)
• Kidney Transplantation (adverse effects)
• Male
• Middle Aged
• RNA, Viral (blood)
• Renal Dialysis (adverse effects)
• Risk Factors
• Seroepidemiologic Studies
• Transplantation
• Young Adult