Acute and Chronic Hepatitis E Virus Infection in HIV-Infected United States Women

Exposure to hepatitis E virus (HEV) is common in the United States (US) but there are few data on prevalence of HEV/HIV co-infection in US populations. We tested 2,919 plasma samples collected from HIV-infected (HIV + ) women and men enrolled in US cohort studies for HEV viremia using a high-throughput nucleic acid testing (NAT) platform. NAT + samples were confirmed by real-time polymerase chain reaction (PCR). Samples were selected for testing primarily on the basis of biomarkers of liver disease and immune suppression. Prevalence of HEV viremia was 3/2,606 and 0/313 in tested plasma samples collected from HIV + women and men, respectively. All HEV isolates were genotype 3a. Based on follow-up testing of stored samples, one woman had chronic HEV infection for >4 years while 2 women had acute HEV detectable at only a single study visit.