Molecular Characterization and Seroprevalence of Hepatitis E Virus in Inflammatory Bowel Disease Patients and Solid Organ Transplant Recipients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Serum Samples
- Patients hospitalized in Hospital of Lithuanian University Health Sciences Kaunas Clinics (HLUHSKC) Gastroenterology clinic and diagnosed with IBD (n = 203). All samples were assigned into 2 groups based on clinical characteristics, namely patients with diagnosed UC (n = 156) or CD (n = 47). In addition, all IBD patients were assigned into groups based on whether they have (n = 42) or have not (n = 161) received biological therapy (anti-tumor necrosis factor (TNF) (infliximab/adalimumab) antibody protocol). Samples from anti-TNF therapy group patients were collected during the maintenance stage of the treatment. Samples were collected from 2015 to 2020, stored, and retrospectively tested for the presence of anti-HEV antibodies and HEV RNA.
- SOT recipients were hospitalized in HLUHSKC Nephrology clinic and Gastroenterology clinic (n = 63). Samples were collected during post-transplantation visitations. All samples were assigned into 2 groups based on allograft type, namely kidney (n = 58) and liver (n = 5). Samples were collected from 2019 to 2020 and tested immediately after collection.
- Healthy control group (n = 100) of individuals without clinical IBD diagnosis or SOT. Sufficient representation of different age groups and genders was achieved by the inclusion of an equal number of samples from each category. Samples were collected from 2015 to 2017, stored, and retrospectively tested for the presence of anti-HEV antibodies and HEV RNA.
2.2. Serological Testing
2.3. Molecular Diagnostics
2.4. Sequencing and Phylogenetic Analysis
2.5. Viral Stock Preparation and Cell Line Infection
2.6. Immunofluorescence Assay and Confocal Microscopy
2.7. Statistical Analysis
3. Results
3.1. HEV Seroprevalence in IBD Patients and SOT Recipients
3.2. RNA Detection and Molecular Characteristics of HEV in Lithuanian IBD Patients and SOT Recipients
3.3. HEV Isolate Propagation in MARC-145 Cells
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Diagnosis | Sample Size (# Tested) | Age Range (Years) | Mean Age ± SD a (Years) | Gender (#M/#F b) |
---|---|---|---|---|
Inflammatory bowel disease | 203 | 18–80 | 40 ± 15 | 118/85 |
Ulcerative colitis | 156 | 18–80 | 40 ± 15 | 89/67 |
W c anti-TNF treatment | 29 | 18–57 | 34 ± 12 | 16/13 |
w/o d anti-TNF treatment | 127 | 19–80 | 43 ± 16 | 73/54 |
Crohn’s disease | 47 | 18–67 | 36 ± 13 | 29/18 |
w anti-TNF treatment | 13 | 19–55 | 34 ± 12 | 9/4 |
w/o anti-TNF treatment | 34 | 18–67 | 38 ± 14 | 20/14 |
Solid organ transplant recipients | 63 | 19–76 | 52 ± 14 | 48/15 |
Liver allograft | 5 | 21–54 | 43 ± 13 | 3/2 |
Kidney allograft | 58 | 19–76 | 52 ± 14 | 45/13 |
Healthy control | 100 | 20–85 | 53 ± 19 | 50/50 |
Total | 366 | 18–85 | 46 ± 17 | 216/150 |
Healthy Control | Test Group Total | |||
---|---|---|---|---|
% IgG a Positive | (95%CI b) | % IgG Positive | (95%CI) | |
Total | 3.0 | (0–6.3) | 12.0 | (8.1–15.9) |
Age (years) | ||||
<29 | 0 | 4.6 | (0–9.6) | |
30–39 | 0 | 18.0 | (7.4–28.7) | |
40–49 | 7.1 | (0–20.6) | 5.0 | (0–10.5) |
50–59 | 0 | 13.3 | (3.4–23.3) | |
60–69 | 0 | 29.0 | (13.1–45.0) | |
≥70 | 6.9 | (0–16.1) | 14.3 | (0–32.6) |
Gender | ||||
Male | 6.0 | (0–12.6) | 10.8 | (6.1–15.6) |
Female | 0 | 14.0 | (7.2–20.8) |
Diagnosis | % IgG a Positive (95%CI b) | % IgM c Positive (95%CI) | % IgG/IgM Positive (95%CI) |
---|---|---|---|
Inflammatory bowel disease | 12.3 (7.8–16.8) | 6.4 (3.0–9.8) | 3.0 (0.6–5.3) |
Ulcerative colitis | |||
≤29 | 6.8 (0–14.3) | 2.3 (0–6.7) | 2.3 (0–6.7) |
30–39 | 18.8 (5.2–32.3) | 6.3 (0–14.6) | 3.1 (0–9.2) |
40–49 | 5.4 (0–12.7) | 8.1 (0–16.9) | 2.7 (0–7.9) |
50–59 | 0 | 4.6 (0–13.3) | 0 |
60–69 | 50.0 (23.8–76.2) | 14.3 (0–32.6) | 14.3 (0–32.6) |
≥70 | 14.3 (0–40.2) | 0 | 0 |
Crohn’s disease | |||
≤29 | 0 | 12.5 (0–28.7) | 0 |
30–39 | 30.0 (1.6–58.4) | 20.0 (0–44.8) | 10.0 (0–28.6) |
40–49 | 0 | 0 | 0 |
50–59 | 25.0 (0–67.4) | 0 | 0 |
60–69 | 66.7 (13.3–100.0) | 0 | 0 |
Solid organ transplant recipients | 11.1 (3.4–18.9) | 3.2 (0–7.5) | 1.6 (0–4.7) |
≤29 | 0 | 0 | 0 |
30–39 | 0 | 0 | 0 |
40–49 | 11.1 (0–31.6) | 0 | 0 |
50–59 | 26.3 (6.5–16.1) | 5.3 (0–15.3) | 5.3 (0–15.3) |
60–69 | 0 | 7.1 (0–20.6) | 0 |
Factors | Anti-HEV a IgG b | |
---|---|---|
Odds Ratio (95% CI c) | p | |
Age (years) | 1.032 (1.007–1.057) | <0.01 |
Anti-TNF therapy | 0 | >0.05 |
Inflammatory bowel disease | 4.541 (1.337–15.426) | <0.01 |
Ulcerative colitis | 5.688 (1.633–19.817) | <0.01 |
Crohn’s disease | 6.929 (1.628–29.487) | <0.01 |
Solid organ transplant received | 4.042 (1.005–16.258) | <0.05 |
Kidney allograft | 4.222 (0.979–18.213) | <0.05 |
Liver allograft | 12.432 (0.992–155.757) | <0.05 |
Gender | 0.958 (0.450–2.038) | >0.05 |
No. | Patient ID | Age | Gender | Diagnosis | HEV ORF1 Positive | HEV ORF2 Positive | Anti-HEV a IgG b Positive | Anti-HEV IgM c Positive |
---|---|---|---|---|---|---|---|---|
1 | BT1 | 22 | Female | UC d with anti-TNF treatment | + | + | − | − |
2 | KA1 | 45 | Female | Kidney allograft recipient | − | + | − | − |
3 | KA2 | 57 | Male | Kidney allograft recipient | + | − | + | − |
4 | KA3 | 76 | Male | Kidney allograft recipient | + | − | − | − |
5 | KA4 | 44 | Male | Kidney allograft recipient | + | − | − | − |
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Grigas, J.; Montoya, M.; Simkute, E.; Buitkus, M.; Zagrabskaite, R.; Pautienius, A.; Razukevicius, D.; Jonaitis, L.V.; Kiudelis, G.; Skieceviciene, J.; et al. Molecular Characterization and Seroprevalence of Hepatitis E Virus in Inflammatory Bowel Disease Patients and Solid Organ Transplant Recipients. Viruses 2021, 13, 670. https://doi.org/10.3390/v13040670
Grigas J, Montoya M, Simkute E, Buitkus M, Zagrabskaite R, Pautienius A, Razukevicius D, Jonaitis LV, Kiudelis G, Skieceviciene J, et al. Molecular Characterization and Seroprevalence of Hepatitis E Virus in Inflammatory Bowel Disease Patients and Solid Organ Transplant Recipients. Viruses. 2021; 13(4):670. https://doi.org/10.3390/v13040670
Chicago/Turabian StyleGrigas, Juozas, Maria Montoya, Evelina Simkute, Marius Buitkus, Ruta Zagrabskaite, Arnoldas Pautienius, Dainius Razukevicius, Laimas Virginijus Jonaitis, Gediminas Kiudelis, Jurgita Skieceviciene, and et al. 2021. "Molecular Characterization and Seroprevalence of Hepatitis E Virus in Inflammatory Bowel Disease Patients and Solid Organ Transplant Recipients" Viruses 13, no. 4: 670. https://doi.org/10.3390/v13040670
APA StyleGrigas, J., Montoya, M., Simkute, E., Buitkus, M., Zagrabskaite, R., Pautienius, A., Razukevicius, D., Jonaitis, L. V., Kiudelis, G., Skieceviciene, J., Vaiciuniene, R., Stankuviene, A., Bumblyte, I. A., Kupcinskas, J., & Stankevicius, A. (2021). Molecular Characterization and Seroprevalence of Hepatitis E Virus in Inflammatory Bowel Disease Patients and Solid Organ Transplant Recipients. Viruses, 13(4), 670. https://doi.org/10.3390/v13040670