Observational studyClinics (Sao Paulo, Brazil)2021
Hepatitis E virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis C virus infection.
Observational study in Clinics (Sao Paulo, Brazil), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 8 citations in OpenAlex.
- Hepatitis E Virus Infection in Patients With Chronic Liver Diseases: A Latin American Multicenter Study.The Journal of infectious diseases · 2026Article
- Global Temporal Trends and Projections of Acute Hepatitis E Epidemiology for Adults 65 Years and Older from 1990 to 2021: Global Burden of Disease 2021 Based Study.Tropical medicine and infectious disease · 2026Article
- Article
- Hepatitis E Virus Infection in Brazil: A Scoping Review of Epidemiological Features.Pathogens (Basel, Switzerland) · 2025Article
- Effect of viral hepatitis on type 2 diabetes: A Mendelian randomization study.World journal of diabetes · 2024Article
- Hepatitis E Virus (HEV) Infection Among Immunocompromised Individuals: A Brief Narrative Review.Infection and drug resistance · 2024Review
- Co-infection of hepatitis E virus,Frontiers in cellular and infection microbiology · 2023Article
- Similarities, differences, and possible interactions between hepatitis E and hepatitis C viruses: Relevance for research and clinical practice.World journal of gastroenterology · 2022Review
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesCo-infection with hepatitis A or B viruses may aggravate liver injury in patients infected with hepatitis C virus (HCV). However, few studies have assessed co-infection with hepatitis E virus (HEV) and HCV. Therefore, this study aimed to assess the prevalence and impact of HEV infection among Brazilian patients with chronic HCV infection.
methodsThis observational study included adult patients with chronic HCV infection who were naive to antiviral therapy from January 2013 to March 2016. A total of 181 patients were enrolled, and HEV serology and PCR were performed for all patients.
resultsSeropositivity for anti-HEV IgG was detected in 22 (12.0%) patients and anti-HEV immunoglobulin M in 3 (1.6%). HEV RNA showed inconclusive results in nine (4.9%) patients and was undetectable in the remaining patients. HEV serology positive patients had more severe liver disease, characterized by liver fibrosis ≥3 versus ≤2 (p<0.001), Aspartate Aminotransferase-to-Platelet Ratio Index of ≥1.45 (p=0.003), and Fibrosis-4 score of ≥3.25 (p=0.001). Additionally, the odds of HEV-positive patients developing diabetes mellitus were 3.65 (95% CI 1.40-9.52) times the corresponding odds of HEV-negative patients. A case-control-based histological analysis (n=11 HEV-HCV-positive patients and n=22 HCV-positive patients) showed no significant differences between the groups.
conclusionsThis prevalence is higher than that reported in previous studies of the general population in Brazil. Thus, HEV infection may influence the severity of liver disease and may represent an additional risk of developing diabetes mellitus in patients with HCV infection.
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