Molecular evaluation of hepatitis E in HIV infected patients in Isfahan, Iran

Hepatitis E virus (HEV) is from Hepeviridae family and genus Hepevirus. This virus is in 4 genotypes. These 4 genotypes are classified in 2 classes. In first class there are genotypes 1 and 2 which are specific for human. Genotypes 1 and 2 are not developed to chronic hepatitis is spite to genotypes 3 and 4 which may develop to chronic hepatitis in immunocompromised patients. It should say that in middle east genotypes 3 and 4 are not frequent. One of the immunodeficiency syndrome is human immunodeficiency virus (HIV) infection in which in the late phases of the disease the power of the immunity will be severely decreased in the patients. Therefore, in patients with HIV infection, HEV (specially genotypes 3 and 4) may be a problem and it may progress to a chronic viral hepatitis which may lead to liver failure. Therefore, it may need treatment and prophylactic strategies in some areas. The aim of this study was to evaluate the frequency of HEV infection in HIV patients by molecular assay.
This descriptive, cross-sectional study was conducted on 111 random selected, known HIV infection patients in 2016 in Isfahan, Iran. This study was done under supervision of Immunodeficiency Research Center of Isfahan University of Medical Sciences. The criteria for enrolling in the study, was positivity of HIV infection, and samples were selected from all known HIV infected patients in Isfahan. After blood sampling from the selected patients, HEV RNA was surveyed by RealStar® HEV RT-PCR Kit 1.0 (Altona Diagnostics, Hamburg, Germany). At the end, after isolation of HEV RNA, the cDNA was prepared and evaluated.
Patients were between 5 to 68 years old and mean of the patients age was 38.5±11.5 years. 75 (67.6%) and 36 (32.4%) of the patients were men and women respectively. Mean count of the CD4 cells in these patients was 317.2±187.8. HBsAg and HCVAb was positive in 6 (5.4%) and 39 (35.1%) of them. No one of the studied patients were positive for HEV infection.
On the results of this study, there is no chance for having hepatitis E infection in Iranian HIV patients. Therefore, it seems that, hepatitis E is not an important problem in this group of patients in Iran.