Two hundred and twelve patients (89%) were on antiretroviral Raf inhibitor treatment; the median CD4 T-cell count was 483 cells/μL [interquartile range (IQR) 313–662 cells/μL] and the HIV viral load was < 25 HIV-1 RNA copies/mL. Overall, 22 patients (9%) were anti-HEV positive. Liver cirrhosis was the only factor independently associated with the presence of anti-HEV,

which was documented in 23% of patients with cirrhosis and 6% of patients without cirrhosis (P = 0.002; odds ratio 5.77). HEV RNA was detected in three seropositive patients (14%), two of whom had liver cirrhosis. Our findings show a high prevalence of anti-HEV in HIV-infected patients, strongly associated with liver cirrhosis. Chronic HEV infection was detected in a significant number of HEV-seropositive patients. Further research is needed to ascertain whether cirrhosis is a predisposing factor for HEV infection and to assess the role of chronic HEV infection PLX-4720 nmr in the pathogeneses of cirrhosis in this population. Hepatitis E virus (HEV) is an enterically transmitted RNA virus. It is a major cause of acute hepatitis outbreaks in endemic areas and acute sporadic cases in industrialized countries, probably as a result of the spread of autochthonous viral strains [1]. HEV infection has been associated with self-limiting acute hepatitis, but progression to chronic hepatitis has been recently described among solid organ

transplant recipients [2, 3]. Data concerning HEV-associated chronic liver disease in HIV-infected patients are scarce and discordant. Some studies have reported the presence of chronic liver disease, whereas others have failed to detect it in this population [4-8]. In Spain, epidemiological studies of HEV infection have been tetracosactide conducted in the general population [9, 10], but no data are available on HEV seroprevalence in HIV-infected patients. Recently, however, the presence of HEV RNA in serum was investigated in a cohort of 93 HIV-infected patients with severe immune depression living in Madrid (in the central region of Spain). None of the patients studied tested positive for HEV RNA, and the authors concluded that HEV infection is uncommon in this population [6]. However, HEV serostatus

was not evaluated in that study In the present study, we determined whether immunoglobulin G (IgG) antibodies to HEV (anti-HEV) were present in serum samples obtained from a large cohort of HIV-infected patients to investigate the prevalence of, and factors associated with, HEV infection in HIV-infected individuals. In this cross-sectional study, carried out at Vall d’Hebron University Hospital (in the eastern region of Spain), all HIV-infected patients consecutively attending the out-patient clinic from April to May 2011 were enrolled. In all 238 finally selected cases, it was determined whether antibodies to HEV (types IgG and IgM) were present in serum samples using an enzyme immunoassay (EIA) (Bioelisa HEV IgG and HEV IgM 3.