mTOR inhibitors a potential predisposing factor for chronic hepatitis E: Results from the prospective collaborative CHES study (Chronic Hepatitis EScreening in patients with immune impairment and increased transaminases levels).

Adult Humans Hepatitis E / drug therapy Prospective Studies MTOR Inhibitors HIV Infections / complications Hepatitis E virus Hepatitis, Chronic / epidemiology Risk Factors Hepatitis Antibodies / therapeutic use Liver Cirrhosis / complications Immunosuppressive Agents / adverse effects RNA, Viral / analysis Immunoglobulin G Transaminases

Chronic hepatitis E Cirrosis hepática HIV infection Hepatitis E virus Hepatitis crónica E Immunosuppression Infección por VIH Inhibidores de mTOR Inmunosupresión Liver cirrhosis Solid-organ transplant Trasplante de órgano sólido Virus de la hepatitis E mTOR inhibitors

Journal

Gastroenterologia y hepatologia

ISSN: 0210-5705

Titre abrégé: Gastroenterol Hepatol

Pays: Spain

ID NLM: 8406671

Informations de publication

Date de publication:
Dec 2023

Historique:

received: 29 07 2022

revised: 03 01 2023

accepted: 21 01 2023

medline: 27 11 2023

pubmed: 3 2 2023

entrez: 2 2 2023

Statut: ppublish

Résumé

Chronic hepatitis E virus (HEV) in persons with immune impairment has a progressive course leading to a rapid progression to liver cirrhosis. However, prospective data on chronic HEV is scarce. The aim of this study was to determine the prevalence and risk factors for chronic HEV infection in subjects with immune dysfunction and elevated liver enzymes. CHES is a multicenter prospective study that included adults with elevated transaminases values for at least 6 months and any of these conditions: transplant recipients, HIV infection, haemodialysis, liver cirrhosis, and immunosuppressant therapy. Anti-HEV IgG/IgM (Wantai ELISA) and HEV-RNA by an automated highly sensitive assay (Roche diagnostics) were performed in all subjects. In addition, all participants answered an epidemiological survey. Three hundred and eighty-one patients were included: 131 transplant recipients, 115 cirrhosis, 51 HIV-infected subjects, 87 on immunosuppressants, 4 hemodialysis. Overall, 210 subjects were on immunosuppressants. Anti-HEV IgG was found in 94 (25.6%) subjects with similar rates regardless of the cause for immune impairment. HEV-RNA was positive in 6 (1.6%), all of them transplant recipients, yielding a rate of chronic HEV of 5.8% among solid-organ recipients. In the transplant population, only therapy with mTOR inhibitors was independently associated with risk of chronic HEV, whereas also ALT values impacted in the general model. Despite previous abnormal transaminases values, chronic HEV was only observed among solid-organ recipients. In this population, the rate of chronic HEV was 5.8% and only therapy with mTOR inhibitors was independently associated with chronic hepatitis E.

Sections du résumé

BACKGROUND BACKGROUND

PATIENTS AND METHODS METHODS

CHES is a multicenter prospective study that included adults with elevated transaminases values for at least 6 months and any of these conditions: transplant recipients, HIV infection, haemodialysis, liver cirrhosis, and immunosuppressant therapy. Anti-HEV IgG/IgM (Wantai ELISA) and HEV-RNA by an automated highly sensitive assay (Roche diagnostics) were performed in all subjects. In addition, all participants answered an epidemiological survey.

RESULTS RESULTS

Three hundred and eighty-one patients were included: 131 transplant recipients, 115 cirrhosis, 51 HIV-infected subjects, 87 on immunosuppressants, 4 hemodialysis. Overall, 210 subjects were on immunosuppressants. Anti-HEV IgG was found in 94 (25.6%) subjects with similar rates regardless of the cause for immune impairment. HEV-RNA was positive in 6 (1.6%), all of them transplant recipients, yielding a rate of chronic HEV of 5.8% among solid-organ recipients. In the transplant population, only therapy with mTOR inhibitors was independently associated with risk of chronic HEV, whereas also ALT values impacted in the general model.

CONCLUSIONS CONCLUSIONS

Despite previous abnormal transaminases values, chronic HEV was only observed among solid-organ recipients. In this population, the rate of chronic HEV was 5.8% and only therapy with mTOR inhibitors was independently associated with chronic hepatitis E.

Identifiants

DOI: 10.1016/j.gastrohep.2023.01.010 PMID: 36731726

pubmed: 36731726

pii: S0210-5705(23)00015-8

doi: 10.1016/j.gastrohep.2023.01.010

pii:

doi:

Substances chimiques

MTOR Inhibitors 0

2-(N-cyclohexylamino)ethanesulfonic acid 103-47-9

Hepatitis Antibodies 0

Immunosuppressive Agents 0

RNA, Viral 0

Immunoglobulin G 0

Transaminases EC 2.6.1.-

Types de publication

Multicenter Study Journal Article

Langues

eng spa

Sous-ensembles de citation

Pagination

764-773