Cryptogenic liver cirrhosis and hepatitis E virus (HEV): Are they related?

Abstract Introduction and Objectives Hepatitis E virus (HEV) is one of the most common causes of acute hepatitis. In recent years, its role in the development of chronic hepatitis and cirrhosis especially in immunosuppressed patients and its wide range of extrahepatic involvement have increased the amount of research on HEV. In this study we aimed to investigate the presence of HEV infection in individuals with cryptogenic cirrhosis. Materials and methods HEV antibodies were analysed using the Anti HEV enzyme-linked immunosorbent assay (ELISA) kit ( anti-HEV ELISA; Diapro Prodiagnostic Bioprobes, Milan, Italy). HEV RNA was isolated with using QIAMP Viral RNA mini kit (QIAGEN, Hilden, Germany). The HEV RNA titre was detected with the Rotor Gene 3000 real time polymerase chain reaction (PCR) system using GenoSen's HEV (Rotor Gene) Quantitative Real Time PCR Kit (Genome Diagnostics Private Limited, the Netherlands). Results Our study included 21 healthy volunteers (12 males) and 35 cryptogenic cirrhosis patients (19 males). The ages of the patients and the controls were similar (46 ± 12.1 vs. 37.5 ± 9.7years). The mean Child–Pugh score was 8 ± 2.5. The anti HEV immunoglobulin G(IgG) positivity rate was 9.5% and 25.7% in the control and patient groups respectively ( p  > 0.05). HEV RNA positivity was not detected in the control group, but 3 cases (8.6%) in the patient group were positive ( p  > 0.05). The HEV RNA, aspartate aminotransferase (AST) and alanine aminotransferase(ALT) levels for these 3 cases were 326.461 copies/mL, 91 IU/L and 67 IU/L; 480 copies/mL, 68 IU/L and 36 IU/L and 72 copies/mL, 42 IU/L and 24 IU/L respectively. There were positive correlations between HEV RNA levels and AST and ALT levels ( p Conclusions Anti HEVIgG and HEV RNA positivity rates are high in cryptogenic cirrhosis although it is not statistically significant and there is a positive correlation between HEV RNA and aminotransferases.