Previous hepatitis E virus infection is associated with increased liver stiffness in patients with autoimmune hepatitis

Autoimmune hepatitis (AIH) is a chronic, progressive liver disease that, in most cases, may require lifelong immunosuppression. Hepatitis E virus (HEV) is a leading cause of acute, typically self‑limited hepatitis worldwide, although immunocompromised patients may develop chronic hepatitis. We aimed to evaluate the impact of HEV seropositivity on the clinical course of AIH. The study involved a group of 374 adult patients with AIH (68% women; median [interquartile range] age, 34 [18-83] years; 38% with liver cirrhosis). Serum HEV immunoglobulin (Ig) G and IgM antibodies were measured by enzyme‑linked immunosorbent assay, liver fibrosis was assessed by liver stiffness measurement (LSM), and liver cirrhosis was confirmed with liver histology or LSM. Fifty‑five patients (15%) with AIH were HEV IgG‑positive. These patients were older (P