Rat hepatitis E virus (Rocahepevirus ratti) in people living with HIV

Emerg Microbes Infect. 2024 Dec;13(1):2295389. doi: 10.1080/22221751.2023.2295389. Epub 2023 Dec 30.

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.

Keywords: HIV; Hepatitis E; Zoonoses; acute hepatitis; public health; rat hepatitis E virus.

Publication types

  • Multicenter Study

MeSH terms

  • Animals
  • HIV Infections* / complications
  • Hepatitis Antibodies
  • Hepatitis E virus* / genetics
  • Hepatitis E* / epidemiology
  • Humans
  • Immunoglobulin G
  • Male
  • RNA, Viral
  • Rats

Substances

  • Hepatitis Antibodies
  • RNA, Viral
  • Immunoglobulin G

Grants and funding

This work was supported by the Andalusian General Secretariat for Research, Development, and Innovation in Health (PI-0287-2019), the Spanish Ministry of Health (RD12/0017/0012), co-financed by European Regional Development Fund (ERDF), and the Carlos III Health Institute (Research Project grant numbers: PI21/00793 and PI22/01098). Projects “PI21/00793” and “PI22/01098” were funded by Carlos III Health Institute (ISCIII) and co-funded by the European Union. ARJ is the recipient of a “Miguel Servet” Research Contract by the Spanish Ministry of Sciences (CP18/00111). JCG is supported by the CIBERINFEC (CB21/13/00083), Carlos III Health Institute, Spanish Ministry os Science and NextGenerationEU. MCJ is the recipient of a PFIS predoctoral grant (FI22/00180) from the Carlos III Health Institute and co-funded by the European Union. DCM is the recipient of a “Rio-Hortega” (CM22/00176) grant from the Carlos III Health Institute and co-funded by the European Union. PLL is the recipient of a “Margarita Salas” contract funded by NextGeneration EU. TGG is recipient of a “Ramon y Cajal” contract funded by MCIN/AEI/10.13039/501100011033 and NextGeneration EU/PRTR. The laboratory of R.G.U. is supported by DZIF Thematic Translational Unit (TTU) “Emerging Infections” (grant number 01.808; awarded to R.G.U.). The HIV BioBank is supported by Carlos III Health Institute (PT20/00138) and Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN (CB22/01/00041). CoRIS cohort is supported by CIBER (CB21/13/00091), Carlos III Health Institute, Spanish Ministry of Sciences NextGenerationEU. The funders did not play any role in the design, conclusions, interpretation of the study, or decision to publish.