• Maciej K Janik, Agnieszka Kempińska-Podhorodecka, Joanna Raszeja-Wyszomirska, Marcin Krawczyk, Małgorzata Milkiewicz, and Piotr Milkiewicz.
• Department of Hepatology, Transplantology and Internal Medicine, Medical University of Warsaw, Warszawa, Poland
• Pol. Arch. Med. Wewn. 2024 May 28; 134 (5).

IntroductionAutoimmune hepatitis (AIH) is a chronic, progressive liver disease that, in most cases, may require lifelong immunosuppression. Hepatitis E virus (HEV) is a leading cause of acute, typically self‑limited hepatitis worldwide, although immunocompromised patients may develop chronic hepatitis.ObjectivesWe aimed to evaluate the impact of HEV seropositivity on the clinical course of AIH.Patients And MethodsThe study involved a group of 374 adult patients with AIH (68% women; median [interquartile range] age, 34 [18-83] years; 38% with liver cirrhosis). Serum HEV immunoglobulin (Ig) G and IgM antibodies were measured by enzyme‑linked immunosorbent assay, liver fibrosis was assessed by liver stiffness measurement (LSM), and liver cirrhosis was confirmed with liver histology or LSM.ResultsFifty‑five patients (15%) with AIH were HEV IgG‑positive. These patients were older (P <0.001), had higher body mass index, and higher value of LSM (both P <0.05). In a multivariable model including the levels of alanine aminotransferase and IgG, the HEV seropositive status was associated with an increased risk of advanced liver fibrosis with odds ratio of 3.69 (95% CI, 1.26-10.77; P = 0.02), as reflected by liver stiffness equal to or above 10.5 kPa. HEV IgG seropositivity was, however, not linked with the type of treatment or worse AIH outcome. Seroprevalence of HEV in the patients with AIH was lower than in the general population of Polish blood donors (43%).ConclusionsPatients with AIH and HEV IgG‑positive status seem to be at risk of more advanced liver fibrosis. However, the overall seroprevalence of HEV IgG is lower in patients with AIH than in blood donors in Poland.

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