Impact of hepatitis E virus seropositivity on chronic liver disease in cancer patients with hepatitis C virus infection

Aim: Immunocompromised patients can develop chronic hepatitis E virus (HEV) infection and progress to cirrhosis. Hepatitis C virus (HCV)-infected cancer patients who have received chemotherapeutic agents experience accelerated liver fibrosis progression. Our aim was to investigate the prevalence and impact of HEV seropositivity on liver-related outcomes in HCV-infected cancer patients. Methods: As part of a prospective study of HCV-infected cancer patients conducted at our center, we investigate the characteristics associated with progression of their liver disease. Results: Of the 115 patients tested, 13 (11%) were positive for HEV immunoglobulin G. HEV seropositivity was associated with advanced age (P=0.004), race (P=0.02), place of birth outside the USA (P=0.021), cirrhosis (P=0.027), history of reused needles/syringes during massive vaccination campaigns (P=0.015) and coronary artery disease (P=0.039). Overall, 47 (41%) of the patients had cirrhosis. Factors independently associated with cirrhosis were male sex (odds ratio [OR], 2.8; P=0.028) and HEV seropositivity (OR, 4.1; P=0.032). Conclusion: HEV seropositivity is present in 11% of HCV-infected cancer patients and seems to be associated with cirrhosis. Our results suggest that HEV screening should be implemented in HCV-infected patients with cancer.