The seroprevalence of autoimmune hepatitis-related autoantibodies in patients with acute hepatitis E is elevated, particularly in women, and acute hepatitis E virus (HEV) infection may be related to autoimmune hepatitis, according to results of a study published in Emerging Microbes & Infections.
Autoimmune hepatitis is a rare chronic inflammatory liver disease and although its etiology is unclear, it may be triggered by viruses. The relationship between HEV and autoimmune hepatitis has been a focus of research and it appears that the virulence of HEV varies according to genotype.
Researchers in China sought to determine whether acute HEV infection in the Chinese population is related to the presence of autoimmune hepatitis-related autoantibodies and to identify possible effects on disease characteristics. A total of 198 patients with HEV and 50 patients with type 1 autoimmune hepatitis patients (controls).
The results of the study found that the seroprevalence of autoimmune hepatitis-related autoantibodies in patients with HEV was elevated, particularly in women, but their subspecificities and titers, as well as the rate of type 1 autoimmune hepatitis were different compared with patients with this disease. They also found that nonspecific autoimmune hepatitis-related autoantibodies are often produced during acute HEV infection, which should thus be excluded when diagnosing autoimmune hepatitis. Immunosuppression can lead to chronic HEV disease and has implications for HEV diagnosis, treatment, and prognosis. Lastly, they found that acute HEV infection may be related to autoimmune hepatitis, but noted that this finding requires further study.
There were several limitations to this study, including that the patients with acute HEV infection that were enrolled in the study were from 4 hospitals in different regions of China; thus, the study may have been subject to selection bias. In addition, although genotype 4 is predominant in China, the researchers did not determine the HEV genotype.
The study authors concluded that, “long-term follow-up of the seroprevalence of AIH-related autoantibodies is needed.”
Wu J, Guo N, Zhu L, et al. Seroprevalence of AIH-related autoantibodies in patients with acute hepatitis E viral infection: a prospective case–control study in China. Emerg Microbes Infect. 2020;9(suppl 1):332-340. doi:10.1080/22221751.2020.1722759