Association between liver fibrosis and hepatitis e seroprevalence among HIV-positive individuals in Nepal

Shemal M. Shah, Jagat B. Baniya, Birendra Prasad Gupta, Ananta Shrestha, Holly Rodin, Andre Boonstra, Jose D. Debes

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


OBJECTIVE: Hepatitis E virus (HEV) seropositivity may confer an increased risk of liver fibrosis in immunosuppressed individuals. We studied this effect in HIV-infected individuals in Nepal, a country hyperendemic for HEV.

PARTICIPANTS AND METHODS: We prospectively evaluated 200 HIV-positive individuals. Serum samples were tested for components of fibrosis scores and cytokeratin-18.

RESULTS: Of 200 patients, 43% were HEV-immunoglobulin G+. The mean fibrosis-4 score was 8.02 in the HEV-positive and 1.17 in the HEV-negative group (P<0.001). The mean nonalcoholic fatty liver disease score was 2.12 in the HEV-positive and -2.53 in the HEV-negative group (P=0.02). The mean aminotransferase-platelet ratio index score was 0.37 in the HEV-positive and 0.38 in the HEV-negative group (P=0.9). The mean cytokeratin-18 levels were 119.9 in the HEV-positive group and 158.6 in the HEV-negative group (P=0.08).

CONCLUSION: We found higher fibrosis-4 and nonalcoholic fatty liver disease scores in HEV-HIV-positive individuals, suggesting an increased liver fibrosis profile in this group. Further studies using liver stiffness measurements should be carried out.

Original languageEnglish (US)
Pages (from-to)503-505
Number of pages3
JournalEuropean Journal of Gastroenterology and Hepatology
Issue number4
StatePublished - Apr 1 2019

Bibliographical note

Publisher Copyright:
Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.


  • HIV
  • hepatitis E virus
  • liver fibrosis
  • Severity of Illness Index
  • Prospective Studies
  • Hepatitis E/complications
  • Humans
  • Male
  • Seroepidemiologic Studies
  • Coinfection/epidemiology
  • Nepal/epidemiology
  • Young Adult
  • Non-alcoholic Fatty Liver Disease/epidemiology
  • HIV Infections/complications
  • Liver Cirrhosis/epidemiology
  • Adolescent
  • Adult
  • Female

PubMed: MeSH publication types

  • Journal Article


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