Hepatitis E virus (HEV) is thought to be common in the United States with increased prevalence in those with concomitant hepatitis C virus (HCV) or HCV/HIV coinfection. Little is known regarding true prevalence, incidence, and antibody seroreversion in these populations. We sought to define these rates among HCV and HCV/HIV coinfected persons in the Washington, DC area. Two longitudinal cohorts of HCV and HCV/HIV coinfected subjects from the Washington, DC area were evaluated. Multiple HEV test modalities were deployed including immunoglobulin G (IgG) and immunoglobulin M (IgM) antibody testing, evaluation of antibody avidity, HEV RNA testing, and HEV enzyme-linked immune absorbent spot (ELISPOT) analysis. A total of 379 individuals were evaluated including 196 who were HCV monoinfected and 183 HCV/HIV coinfected. Anti-HEV IgG was detected and confirmed in 18.7% of the cohort at baseline. None demonstrated anti-HEV IgM positive or HEV RNA positive results. Proportions of HEV antibody prevalence did not significantly differ between groups. Longitudinal follow-up samples were available for 226 individuals with a mean follow-up time of 24 months. Seroreversion was noted in 1.8%. One HCV/HIV infected person seroconverted to HEV IgG positivity in the followed cohort. About 40% of the positive population demonstrated high avidity suggestive of more remote exposure. Interferon gamma ELISPOT was performed in 70 subjects and false negative and false positive HEV enzyme-linked immunosorbent assay antibodies were identified. In HIV-infected persons in the United States HEV exposure and seroconversion is frequent enough that HEV should be considered in the differential diagnosis of acute hepatitis. Seroreversion may lead to underestimation of true infection risk.

中文翻译：

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丙型肝炎病毒和 HCV/HIV 合并感染者的纵向队列中的戊型肝炎感染

戊型肝炎病毒 (HEV) 被认为在美国很常见，伴随丙型肝炎病毒 (HCV) 或 HCV/HIV 合并感染者的患病率增加。关于这些人群的真实患病率、发病率和抗体血清逆转，我们知之甚少。我们试图在华盛顿特区地区的 HCV 和 HCV/HIV 合并感染者中确定这些比率。对来自华盛顿特区的两个 HCV 和 HCV/HIV 共感染受试者的纵向队列进行了评估。部署了多种 HEV 测试方式，包括免疫球蛋白 G (IgG) 和免疫球蛋白 M (IgM) 抗体测试、抗体亲和力评估、HEV RNA 测试和 HEV 酶联免疫吸收点 (ELISPOT) 分析。共评估了 379 人，其中 196 人是 HCV 单一感染者，183 人是 HCV/HIV 合并感染者。基线时在 18.7% 的队列中检测到并确认了抗 HEV IgG。没有人显示出抗 HEV IgM 阳性或 HEV RNA 阳性结果。HEV 抗体流行的比例在各组之间没有显着差异。纵向随访样本可用于 226 个人，平均随访时间为 24 个月。血清逆转发生率为 1.8%。在随后的队列中，一名 HCV/HIV 感染者血清转化为 HEV IgG 阳性。大约 40% 的阳性人群表现出高亲和力，表明更远距离暴露。在 70 名受试者中进行了干扰素 γ ELISPOT，并鉴定了假阴性和假阳性 HEV 酶联免疫吸附测定抗体。在美国的 HIV 感染者中，HEV 暴露和血清转换非常频繁，因此在急性肝炎的鉴别诊断中应考虑 HEV。血清逆转可能导致低估真正的感染风险。