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

Autor:	Kounis I; Centre Hépato-Biliaire, AP-HP Hôpital Paul-Brousse, 94800 Villejuif, France.; Inserm, UMR-S 1193, Université Paris-Saclay, 94800 Villejuif, France.; Inserm, Physiopathogénèse et Traitement des Maladies du Foie, Université Paris-Saclay, 94800 Villejuif, France.; FHU Hepatinov, 94805 Villejuif, France., Renou C; Centre Hospitalier de Hyères, 83400 Hyères, France., Nahon S; Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, 78515 Le Raincy, France., Heluwaert F; Centre Hospitalier Annecy Genevois, 74000 Annecy, France., Macaigne G; Centre Hospitalier Marne-La-Vallée, 77420 Marne La Vallee, France., Amil M; Centre Hospitalier Departemental Vendée, 85000 La Roche sur Yon, France., Talom S; Centre Hospitalier de Meaux, 77100 Meaux, France., Lambare B; Centre Hospitalier Sud Francilien, 91100 Corbeil Essonne, France., Charpignon C; Institut Mutualiste Montsouris, 75014 Paris, France., Paupard T; Centre Hospitalier de Dunkerke, 59140 Dunkerke, France., Stetiu M; Centre Hospitalier Eure-Seine, 27000 Evreux, France., Ripault MP; Centre Hospitalier Béziers, 34032 Béziers, France., Yamaga A; Centre Hospitalier Intercommunal de Poissy-St-Germain-en-Laye, 78100 St-Germain-en-Laye, France., Ehrhard F; Centre Hospitalier Bretagne-Sud, 56100 Lorient, France., Audemar F; Centre Hospitalier Côte Basque, 64100 Bayonne, France., Ortiz Correro MC; Centre Hospitalier de Perpignan, 66000 Perpignan, France., Zanditenas D; Centre Hospitalier Bry-Sur-Marne, 94360 Bry sur Marne, France., Skinazi F; Centre Hospitalier Saint-Denis, 93205 Saint Denis, France., Agostini H; Clinical Research Unit, Université Paris-Sud, Université Paris-Saclay, 94800 Villejuif, France., Coilly A; Centre Hépato-Biliaire, AP-HP Hôpital Paul-Brousse, 94800 Villejuif, France.; Inserm, UMR-S 1193, Université Paris-Saclay, 94800 Villejuif, France.; Inserm, Physiopathogénèse et Traitement des Maladies du Foie, Université Paris-Saclay, 94800 Villejuif, France.; FHU Hepatinov, 94805 Villejuif, France., Roque-Afonso AM; Inserm, UMR-S 1193, Université Paris-Saclay, 94800 Villejuif, France.; Inserm, Physiopathogénèse et Traitement des Maladies du Foie, Université Paris-Saclay, 94800 Villejuif, France.; FHU Hepatinov, 94805 Villejuif, France.; Département de Virologie, AP-HP Hôpital Paul-Brousse, 94800 Villejuif, France.
Jazyk:	angličtina
Zdroj:	Pathogens (Basel, Switzerland) [Pathogens] 2023 Feb 15; Vol. 12 (2). Date of Electronic Publication: 2023 Feb 15.
DOI:	10.3390/pathogens12020332
Abstrakt:	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. Competing Interests: The authors declare no conflict of interest.
Databáze:	MEDLINE
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