P-5 HEPATITIS E VIRUS INFECTION INCREASES THE RISK OF DIABETES AND MORTALITY IN HCV infected patients

Abstract

Co-infection with hepatitis A or B viruses may aggravate liver injury in hepatitis C virus (HCV) infected patients. However, few studies have assessed hepatitis E virus (HEV) and HCV coinfection. Our goal was to assess the prevalence and impact of HEV infection among Brazilian patients with chronic hepatitis C virus. This cross-sectional study included adult patients with chronic HCV infection, naïve to antiviral therapy. Prospectively and consecutively recruited from January 2013 to March 2016. 181 patients were enrolled and HEV serology and PCR were performed for all patients. Seropositivity for anti-HEV IgG was detected in 22 (12.0%) and for anti-HEV IgM in 3 (1.6%) patients. HEV RNA was inconclusive in 9 (4.9%) and undetectable in the remaining cases. HEV serology positive cases had more severe liver disease, characterized by liver fibrosis ≥3 vs ≤2 (p<0.001), APRI (≥1.45) (p=0.003) and FIB-4 (≥3.25) (p=0.001), respectively. Additionally, the odds of diabetes mellitus for HEV positive patients was 3.11 (95%CI 0.99-9.97) times the corresponding odds for HEV negative patients. Furthermore, HEV positive patients had significantly lower survival when compared to their HEV-negative counterparts (p=0.0016 for death and p=0.0067 for death or transplantation endpoint). Although seroprevalence of HEV was low, this infection may influence the severity of liver disease and may represent an additional risk for developing diabetes mellitus in HCV patients.