Acute and Chronic Hepatitis E Virus Infection in Human Immunodeficiency Virus-Infected U.S. Women

Mark H. Kuniholm, Edgar Ong, Boris M. Hogema, Marco Koppelman, Kathryn Anastos, Marion G. Peters, Eric C. Seaberg, Yue Chen, Kenrad E. Nelson, Jeffrey M. Linnen

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Exposure to hepatitis E virus (HEV) is common in the United States, but there are few data on prevalence of HEV/human immunodeficiency virus (HIV) coinfection in U.S. populations. We tested 2,919 plasma samples collected from HIV-infected (HIV+) women and men enrolled in U.S. cohort studies for HEV viremia using a high-throughput nucleic acid testing (NAT) platform. NAT+ samples were confirmed by real-time polymerase chain reaction. Samples were selected for testing primarily on the basis of biomarkers of liver disease and immune suppression. Prevalence of HEV viremia was 3 of 2,606 and 0 of 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, 1 woman had chronic HEV infection for >4 years whereas 2 women had acute HEV detectable at only a single study visit. Conclusions: To our knowledge, this is the first reported case of chronic HEV infection in an HIV+ U.S. individual. We also confirm that chronic HEV infection can persist despite a CD4+ count >200 cells/mm3. Overall, though, these data suggest that HEV infection is rare in the HIV+ U.S. population.

Original languageEnglish (US)
Pages (from-to)712-720
Number of pages9
Issue number3
StatePublished - Mar 1 2016

ASJC Scopus subject areas

  • Hepatology


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