{"id":1860,"date":"2009-10-01T01:00:00","date_gmt":"2009-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/etude-sero-virologique-du-virus-de-lhepatite-e-dans-une-cohorte-de-malades-infectes-par-le-virus-de-limmunodeficience-humaine\/"},"modified":"2018-10-20T18:39:48","modified_gmt":"2018-10-20T16:39:48","slug":"etude-sero-virologique-du-virus-de-lhepatite-e-dans-une-cohorte-de-malades-infectes-par-le-virus-de-limmunodeficience-humaine","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/etude-sero-virologique-du-virus-de-lhepatite-e-dans-une-cohorte-de-malades-infectes-par-le-virus-de-limmunodeficience-humaine\/","title":{"rendered":"Etude s\u00e9ro-virologique du virus de l\u2019h\u00e9patite E dans une cohorte de malades infect\u00e9s par le virus de l\u2019immunod\u00e9ficience humaine"},"content":{"rendered":"

2009<\/strong><\/p>\n

(1) C Renou, (2) A Lafeuillade, (3) A Pariente, (4) JF Cadranel, (5) N Pavio, (6) T Allegre, (7) C Wartelle, (8) J Gaillat, (9) F Heluwaert, (10) C Poggi, (11) G Peraranda, (12) E Nicand, pour l\u2019ANGH
\nH\u00f4pital de jour, CH Hy\u00e8res (1), Service d\u2019infectiologie, CHITS Toulon (2), Unit\u00e9 d\u2019h\u00e9pato-gastroent\u00e9rologie, CH Pau (3), Service d\u2019h\u00e9pato-gastroent\u00e9rologie, CH Creil (4), UMR 1161 Virologie AFSSA LERPAZ-ENVA-INRA, Ecole Nationale V\u00e9t\u00e9rinaire d’Alfort, Maisons-Alfort (5), Service d\u2019infectiologie, CH Aix-en-Provence (6), Service d\u2019h\u00e9pato-gastroent\u00e9rologie, CH Aix-en-Provence (7), Service d\u2019infectiologie, CH Annecy (8), Service d\u2019h\u00e9pato-gastroent\u00e9rologie, CH Annecy (9), Service de virologie, CHITS Toulon (10), D\u00e9partement de Biostatistiques, CDL Pharma, Marseille (11), Centre national de r\u00e9f\u00e9rence des h\u00e9patites ent\u00e9rotransmissibles, H\u00f4pital du Val-de-Gr\u00e2ce, Paris (12)<\/em><\/p>\n

H\u00e9patologie <\/strong>– \u00a02009-05-14 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

H\u00f4pital du Val-de-Gr\u00e2ce, Paris (12)
\nLa d\u00e9tection d\u2019un taux variable d\u2019anticorps anti-VHE a \u00e9t\u00e9 retrouv\u00e9e dans diff\u00e9rentes enqu\u00eates de s\u00e9ropr\u00e9valence r\u00e9alis\u00e9es chez les malades infect\u00e9s par le VIH. Plus r\u00e9cemment, plusieurs des cas d\u2019h\u00e9patite E aigu\u00eb \u00e9taient rapport\u00e9s dans cette population dans diff\u00e9rents pays industrialis\u00e9s.
\nBut : \u00e9valuer de mani\u00e8re prospective, en France, la s\u00e9ropr\u00e9valence et la vir\u00e9mie du VHE dans une population de malades infect\u00e9s par le VIH.
\nM\u00e9thode : les malades infect\u00e9s par le VIH et suivis par 3 services d\u2019infectiologie \u00e9taient inclus entre janvier et mars 2009. Le dosage des IgG anti-VHE, des IgM anti-VHE (EIAgen HEV IgG, EIAgen HEV IgM, Adaltis) et la d\u00e9tection du g\u00e9nome du VHE (technique maison) \u00e9taient r\u00e9alis\u00e9s sur chaque s\u00e9rum. La d\u00e9termination de l\u2019index d\u2019avidit\u00e9 des IgG \u00e9tait effectu\u00e9e pour tout \u00e9chantillon qui pr\u00e9sentait une r\u00e9activit\u00e9 IgG anti-VHE. L\u2019exploitation statistique des r\u00e9sultats \u00e9tait r\u00e9alis\u00e9e suivant les profils s\u00e9rologiques : groupe IgG+ vs IgG- et groupe IgG+\/IgM- vs IgG+\/IgM+ (test du Chi-deux, test de Fisher test de Wilcoxon et de Kuiper).
\nR\u00e9sultats : 135 malades \u00e9taient inclus (\u00e2ge moyen = 50,5+\/-10,8 ans, sex-ratio = 0,68, 93% de la population d\u2019origine Caucasienne). Le bilan biologique h\u00e9patique \u00e9tait perturb\u00e9 dans 40% des cas [cytolyse (20%), cholestase (10%), cytolyse et cholestase (10%)] dans un contexte d\u2019h\u00e9patopathie connue (14%) ou non \u00e9tiquet\u00e9e (26%). Le taux moyen des CD4 \u00e9tait de 577+\/-356 par mm3 alors que celui des CD8 \u00e9tait de 884+\/-543 par mm3. Quinze malades (11,3%) pr\u00e9sentaient une positivit\u00e9 des IgG anti-VHE isol\u00e9e (12\/15) ou associ\u00e9e \u00e0 une positivit\u00e9 des IgM anti-VHE (3\/15). La d\u00e9tection des IgM anti-VHE, chez les 3 malades (2,2%), associ\u00e9s \u00e0 une cytolyse (ALAT \u00e0 8N, 12N et 85N) et \u00e0 une cholestase biologique \u00e9tait en faveur d\u2019une h\u00e9patite E r\u00e9cente ; la vir\u00e9mie du VHE n\u2019\u00e9tait d\u00e9tect\u00e9e que chez 2 des 3 malades mais la faible avidit\u00e9 des IgG anti-VHE chez le troisi\u00e8me confirmait un contact r\u00e9cent avec le VHE. Le rapport CD4\/CD8 des malades avec une r\u00e9activit\u00e9 des IgG anti-VHE \u00e9tait inf\u00e9rieur \u00e0 celui des malades sans marqueurs de l\u2019h\u00e9patite E (8,2% vs 11,4%, p=0,06). Les param\u00e8tres du bilan biologique h\u00e9patique, en particulier le taux de bilirubine totale (2,13N vs 1,1N, p=0,006), \u00e9taient plus \u00e9lev\u00e9s chez les malades IgG+\/IgM+ que chez les malades IgG+\/IgM-.
\nConclusions : 1) les malades infect\u00e9s par le VIH constitue une population \u00e0 risque pour le VHE, 2) la d\u00e9tection des IgM anti-VHE associ\u00e9s \u00e0 une cytolyse h\u00e9patique et une faible avidit\u00e9 des IgG et\/ou une vir\u00e9mie positive du VHE, et retrouv\u00e9e chez 2,2% des malades, est en faveur de l\u2019existence d\u2019une infection r\u00e9cente par le VHE, 3) la d\u00e9marche diagnostique effectu\u00e9e dans le cadre d\u2019une h\u00e9patite cytolytique chez un malade infect\u00e9 par le VIH doit comprendre l\u2019\u00e9tude des marqueurs de l\u2019h\u00e9patite E.<\/p>\n","protected":false},"excerpt":{"rendered":"

2009 (1) C Renou, (2) A Lafeuillade, (3) A Pariente, (4) JF Cadranel, (5) N Pavio, (6) T Allegre, (7) C Wartelle, (8) J Gaillat, (9) F Heluwaert, (10) C Poggi, (11) G Peraranda, (12) E Nicand, pour l\u2019ANGH H\u00f4pital de jour, CH Hy\u00e8res (1), Service d\u2019infectiologie, CHITS Toulon (2), Unit\u00e9 d\u2019h\u00e9pato-gastroent\u00e9rologie, CH Pau (3), […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[20],"class_list":["post-1860","post","type-post","status-publish","format-standard","hentry","category-hepatologie","tag-20"],"yoast_head":"\nEtude s\u00e9ro-virologique du virus de l\u2019h\u00e9patite E dans une cohorte de malades infect\u00e9s par le virus de l\u2019immunod\u00e9ficience humaine - 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