We aimed to characterize the contribution of hepatitis E virus (HEV) in perpetuating the cytokine-mediated inflammatory setting related to liver damage in the context of obesity. Herein, serum samples from patients with liver disease were retrospectively analyzed and categorized as normal-weight patients (NW), overweight patients (OW), obese patients (ObP), and high alcohol consumer patients (HAC), and biochemical, anthropometrical, and transient elastography measurements were obtained. The positivity for immunoglobulin M (IgM) and immunoglobulin G (IgG) anti-HEV antibodies in samples was determined by enzyme-linked immunosorbent assay. Available samples from ObP were tested by reverse transcription–nested polymerase chain reaction for the presence of HEV-RNA. Cytokine profile in the serum of ObP was identified using a multiplexed immune assay. Globally, the highest frequency of IgG anti-HEV was found in ObP (57.5%), followed by HAC (20%), OW (15%), and NW (7.5%). A strong association between HEV serology and obesity was found (odds ratio = 4.21, confidence interval = 1.91.9.27) with a cutoff of 29.3 kg/m² (area under curve [AUC] = 0–66; p = 0.003) and, a 23.7% of available samples of ObP provided amplification of HEV genome. Cytokine analysis revealed significantly higher levels of proinflammatory cytokines (interleukin [IL]-12, interferon [IFN]-γ, and IL-1β) in IgG anti-HEV-positive ObP than in IgG anti-HEV-negative ObP. Moreover, a high proportion of patients with positive serology showed advanced liver damage. In conclusion, the high percentage of anti-HEV antibodies and viral RNA detection in the setting of an excess of fat, along with an associated proinflammatory cytokine profile found in IgG anti-HEV-positive ObP with more severe liver disease, support an interplay between HEV and obesity.

中文翻译：

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戊型肝炎病毒感染的肥胖患者炎症细胞因子谱增加的证据：对慢性肝病的影响

我们旨在表征戊型肝炎病毒 (HEV) 在使与肥胖背景下的肝损伤相关的细胞因子介导的炎症环境中的作用。在此，对肝病患者的血清样本进行回顾性分析，并将其分为正常体重患者（NW）、超重患者（OW）、肥胖患者（ObP）和酗酒患者（HAC），以及生化、人体测量和获得瞬时弹性成像测量值。通过酶联免疫吸附测定法确定样品中免疫球蛋白 M (IgM) 和免疫球蛋白 G (IgG) 抗 HEV 抗体的阳性。来自 ObP 的可用样品通过逆转录嵌套聚合酶链反应检测 HEV-RNA 的存在。ObP 血清中的细胞因子谱使用多重免疫测定法进行鉴定。在全球范围内，IgG 抗 HEV 的频率最高的是 ObP (57.5%)，其次是 HAC (20%)、OW (15%) 和 NW (7.5%)。发现 HEV 血清学与肥胖之间有很强的关联（优势比 = 4.21，置信区间 = 1.91.9.27），临界值为 29.3 kg/m²（曲线下面积 [AUC] = 0–66；p  = 0.003）并且，23.7% 的 ObP 可用样本提供了 HEV 基因组的扩增。细胞因子分析显示，IgG 抗 HEV 阳性 ObP 中的促炎细胞因子（白细胞介素 [IL]-12、干扰素 [IFN] -γ和 IL- 1β）水平显着高于IgG 抗 HEV 阴性 ObP。此外，高比例的血清学阳性患者表现出晚期肝损伤。总之，在脂肪过多的情况下，高比例的抗 HEV 抗体和病毒 RNA 检测，以及在具有更严重肝病的 IgG 抗 HEV 阳性 ObP 中发现的相关促炎细胞因子谱，支持了两者之间的相互作用。 HEV 和肥胖。