Analysis of HEV infection rates in immunocompetent MPGN patients compared to controls

Background Hepatitis B and C, are well-known causes of membranoproliferative glomerulonephritis (MPGN). Recently, hepatitis E virus (HEV) infections in immunosuppressed patients have been linked to the development of MPGN. This study aims, to investigate a possible association of HEV infections and MPGN in immunocompetent individuals.

Methods: A retrospective cohort of 73 MPGN patients was tested for anti-HEV IgG and IgM. A cohort of 1000 random blood donors and a cohort of 73 age- and sex-matched-pair blood donors served as control groups.

Results In the MPGN cohort, 21 patients (29%) tested anti-HEV IgG positive (1.4%), while in the random blood donor cohort, only 17% of patients (n=166) tested IgG positive (p=0.01) and 25% of patients in the matched-pair cohort of 73 blood donors were positive for anti-HEV IgG (p=0.71). MPGN patients were significantly older and more often males compared to the unmatched blood donor cohort.

In the MPGN cohort, anti-HEV IgG positivity was found in 36% of males (17/47) but only 15% (4/26) of females (p=0.05). Anti-HEV IgG positive MPGN patients were older when compared to anti-HEV IgG negative MPGN patients, albeit the difference did not reach statistical significance (median 63 years vs. 53 years, p=0.06).

Conclusion: Although anti-HEV IgG positivity is more common in patients with MPGN compared to healthy blood donors, this difference does not hold up when a cohort of blood donors of similar age and gender is studied. Thus, previous HEV infections are not a relevant trigger for the development of MPGN in immunocompetent patients.

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Artikel online veröffentlicht:
20. Januar 2025