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Hepatitis E Virus Infection in Patients with Chronic Inflammatory Bowel Disease Treated with Immunosuppressive Therapy

Authors :
Ilias Kounis
Christophe Renou
Stephane Nahon
Frederic Heluwaert
Gilles Macaigne
Morgane Amil
Stephane Talom
Benedicte Lambare
Claire Charpignon
Thierry Paupard
Monica Stetiu
Marie Pierre Ripault
Armand Yamaga
Florent Ehrhard
Franck Audemar
Maria Carmen Ortiz Correro
David Zanditenas
Florence Skinazi
Helene Agostini
Audrey Coilly
Anne Marie Roque-Afonso
Source :
Pathogens, Vol 12, Iss 2, p 332 (2023)
Publication Year :
2023
Publisher :
MDPI AG, 2023.

Abstract

Background: Medical treatment of inflammatory bowel disease (IBD) has evolved significantly, and treatment with immunomodulators is recommended. These medications may alter the patient’s immune response and increase the risk of opportunistic infections. Our aim was to evaluate the prevalence and the incidence of acute or chronic HEV infection in IBD patients under immunomodulatory treatment. Patients and Methods: We conducted a retrospective, multicenter, observational study between 2017 and 2018. IBD outpatients hospitalized for the infusion of immunomodulators were included in 16 French centers. During their daily hospitalization, blood samples were drawn for HEV serology (IgM and IgG) and HEV RNA detection. Results: A total of 488 patients were included, of which 327 (67%) patients had Crohn’s disease and 161 (33%) ulcerative colitis. HEV IgM was detected in 3 patients, but HEV RNA was undetectable in all patients. The HEV IgG seroprevalence rate was 14.2%. IgG-positive patients were older at sampling (p = 0.01) and IBD diagnosis (p = 0.03), had higher seafood consumption (p = 0.01) and higher doses of azathioprine (p = 0.03). Ileal and upper digestive tract involvement was more frequent in IgG-positive patients (p = 0.009), and ileocolic involvement was more frequent in IgG-negative patients (p = 0.01). Under multivariate analysis, age > 50 years [OR: 2.21 (1.26, to 3.85), p = 0.004] was associated with previous HEV infection. Conclusion: Systematic screening for HEV infection is not needed among IBD patients on immunomodulatory medications. However, in the event of abnormal liver test findings, HEV should be part of the classic diagnostic assessment.

Details

Language :
English
ISSN :
20760817
Volume :
12
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Pathogens
Publication Type :
Academic Journal
Accession number :
edsdoj.5c195201b8345258c8d41a526cfbfe5
Document Type :
article
Full Text :
https://doi.org/10.3390/pathogens12020332