https://orcid.org/0000-0001-5740-6675
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ABSTRACT
Rat hepatitis E virus (ratHEV; species Rocahepevirus ratti) is considered a newly emerging cause of acute hepatitis of zoonotic origin. ratHEV infection of people living with HIV (PLWH) might portend a worse, as with hepatitis E virus (HEV; species Paslahepevirus balayani), and consequently this group may constitute a high-risk population. We aimed to evaluate the prevalence of ratHEV by measuring viral RNA and specific IgG antibodies in a large Spanish cohort of PLWH. Multicentre study conducted in Spain evaluating PLWHIV included in the Spanish AIDS Research Network (CoRIS). Patients were evaluated for ratHEV infection using PCR at baseline and anti-ratHEV IgG by dot blot analysis to evaluate exposure to ratHEV strains. Patients with detectable ratHEV RNA were followed-up to evaluate persistence of viremia and IgG seroconversion. Eight-hundred and forty-two individuals were tested. A total of 9 individuals showed specific IgG antibodies against ratHEV, supposing a prevalence of 1.1 (95% CI; 0.5%−2.1%). Of these, only one was reactive to HEV IgG antibodies by ELISA. One sample was positive for ratHEV RNA (prevalence of infection: 0.1%; 95% CI: 0.08%−0.7%). The case was a man who had sex with men exhibiting a slightly increased alanine transaminase level (49 IU/L) as only biochemical alteration. In the follow-up, the patients showed undetectable ratHEV RNA and seroconversion to specific ratHEV IgG antibodies. Our study shows that ratHEV is geographical broadly distributed in Spain, representing a potential zoonotic threat.
Acknowledgements
We gratefully acknowledge Gema Dolores Garcia Delgado and Ismael Zafra Soto for their technical support in sample processing and analysis. We would like to especially thank Calvin Mehl, Anna Brück, Patrick Slowikowski and Dörte Kaufmann for support in generation of the recombinant antigens. This study would not have been possible without the collaboration of all patients, medical and nursing staff and data mangers who have taken part in the project. All the members of the CoRIS are included in the Supplementary material.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
All of the data generated or analyzed during the study are included in the article. The datasets used and/or analyzed during the present research project are available from the corresponding author upon reasonable request. The viral sequence is available in GenBank under accession number OP79379.
Authors’ contributions
ARJ and AR were involved in the study design and conception, interpretation of the data, drafting of the manuscript, study supervision, and funding obtention. PLL, MCJ and JCG coordinated sample reception, perform RNA extraction and molecular determinations, phylogenetic analysis and GenBank submission. MCJ and TGG were involved in dot blots and western blot analyses with the advice and supervision of RGU. DCM, AR, IPV, MLM, RNS, JP, NE and MRAV were involved in human sampling collection, ethical committee submission and approval management, and clinical data collection. All authors have revised the manuscript and approved its publication.