HIV, HEV and cirrhosis: evidence of a possible link from eastern Spain

Objectives The aim of the study was to assess the seroprevalence of hepatitis E virus (HEV) infection in an HIV‐infected population, as determined by HEV immunoglobulin G (IgG) antibodies (anti‐HEV). Methods The design of the study was cross‐sectional. Serum anti‐HEV IgG was determined by enzyme immunoassay in 238 HIV‐infected patients consecutively attending our out‐patient clinic between April and May 2011. In HEV‐seropositive patients, HEV RNA was analysed by nested reverse transcriptase–polymerase chain reaction (RT‐PCR). Associations between anti‐HEV and liver cirrhosis, route of HIV infection, hepatitis B virus (HBV) and hepatitis C virus (HCV) serological markers, age, sex and alanine aminotransferase (ALT) levels were examined by univariate and multivariate analysis. Results One hundred and forty patients (59%) had chronic liver disease (99% were HBV‐ and/or HCV‐coinfected). Liver cirrhosis was detected in 44 individuals (19%). Two hundred and twelve patients (89%) were on antiretroviral treatment; the median CD4 T‐cell count was 483 cells/μL [interquartile range (IQR) 313–662 cells/μL] and the HIV viral load was