The hepatitis E virus prevalence in autoimmune hepatitis

Abstract

Background and aim: Autoimmune hepatitis (AIH) is an autoimmune liver disease that occurs predominantly in female gender. Increased serum IgG levels, the presence of autoantibodies and distinct histological features in the lake of other reason liver disease characterize AIH. HEV is a single-stranded RNA virus of the Orthohepevirus genus. Person to person transmission is rare and the main route of transmission of HEV is fecal-oral due to polluted water which is the main cause. The aim of the current systematic review is to investigate the published literature in the field of the HEV prevalence in AIH patients. Materials and methods: The conducted search was performed in electronic databases including EMBASE, Scopus, PubMed and Science Direct for terms, ‘hepatitis’, ‘autoimmune hepatitis’, ‘HEV’, ‘Hepatitis E virus’ and ‘Hepatitis E infection’. The search was performed without any date limitation in 14 February 2019. Results: Search implementation strategies leads to 10 768 studies in all of the assessed databases. The screening and full text assessment leads to eight research studies and eight case reports in this field. The investigation included 1107 AIH patients and 760 controls. The age range was 18—79 years and the female gender reports more in all analyses. Research studies in the field of the HEV prevalence in AIH mostly focused in the anti-HEV IgG evaluation by Immunoassay technics. The anti-HEV IgG prevalence ranged from 7.7 to 50% in AIH patients. Conclusion: The anti-HEV IgG prevalence seems to be highly variable based on the geographical location and patient's population in AIH. Further studies in this field are required for clear conclusion about the HEV role in AIH development.