HEV seroprevalence and associated risk factors among HIV-positive individuals in post-earthquake Kathmandu: a 2016 cross-sectional study
Abstract Introduction Hepatitis E virus (HEV) infection poses a significant public health challenge, particularly in immunocompromised populations such as those living with HIV. Limited data exist on HEV seroprevalence and its correlates among HIV-positive individuals in urban low-resource settings,...
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BMC
2025-08-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-025-11382-8 |
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| author | Chandramani Wagle Jagat Bahadur Baniya Nirmal Aryal Dinesh Prasad Ghimire Ajay Kumar Sah Abhay Kumar Sah Vivek Prasad Gupta Birendra Prasad Gupta |
| author_facet | Chandramani Wagle Jagat Bahadur Baniya Nirmal Aryal Dinesh Prasad Ghimire Ajay Kumar Sah Abhay Kumar Sah Vivek Prasad Gupta Birendra Prasad Gupta |
| author_sort | Chandramani Wagle |
| collection | DOAJ |
| description | Abstract Introduction Hepatitis E virus (HEV) infection poses a significant public health challenge, particularly in immunocompromised populations such as those living with HIV. Limited data exist on HEV seroprevalence and its correlates among HIV-positive individuals in urban low-resource settings, especially in the aftermath of disasters. This study investigates HEV seroprevalence and risk factors among HIV positive individuals in 2016, a post-earthquake period in Kathmandu, Nepal, with relevance to ongoing challenges in 2025. Methods We conducted a cross-sectional serological study among 200 HIV-positive individuals from Sukraraj Tropical and Infectious Disease Hospital’s (STIDH) Antiretroviral Therapy (ART) center in Kathmandu. Serological testing determined anti-HEV IgG and IgM status using Wantai Hepatitis E (HEV-IgG/M) ELISA kits. Sociodemographic, behavioral, and clinical data were collected via structured interviews and medical records. Multivariable logistic regression identified independent predictors of anti-HEV IgG seropositivity. Statistical analyses used Chi-square, Mann-Whitney U, and Cochran’s Q tests, with p < 0.05 considered significant. A comparative general population sample (n = 100) from earthquake-affected districts was also analyzed. Results Overall, 43.5% (87/200) of HIV-positive participants tested positive for anti-HEV IgG. Key demographic predictors included increasing age, which showed a significant non-linear association (adjusted OR = 3.95 for age, 0.60 for age²; p < 0.001), and a marginal association with male gender (aOR = 2.03; p = 0.059). In contrast, no significant associations were observed between HEV seropositivity and specific drinking water sources, water processing methods, eating habits, smoking status, CD4 count, HIV viral load suppression, common comorbidities, or routine liver and hematological markers. anti-HEV IgG seroprevalence was considerably higher than that of Hepatitis B virus (4.5%) and Hepatitis C virus (5.0%) in the cohort and notably absent in a comparative general population sample. The predictive model showed good performance (AUC = 0.80), supporting its exploratory utility. Conclusion Our findings reveal a high burden of past HEV exposure among HIV-positive individuals in post-earthquake Kathmandu, with age being a key correlate. The absence of HEV IgG positivity in the general population sample suggests that HEV exposure during this period may have been localized to vulnerable clinical groups. The lack of association with traditional behavioral or clinical markers highlights the complexity of transmission in this setting. These results underscore the need to integrate HEV awareness and targeted screening into HIV care in endemic regions. Future studies should prioritize longitudinal follow-up, genotype surveillance, and environmental sampling to inform public health preparedness and response. |
| format | Article |
| id | doaj-art-e6e332d7074c4042bc2c1e7165757180 |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-e6e332d7074c4042bc2c1e71657571802025-08-20T03:45:47ZengBMCBMC Infectious Diseases1471-23342025-08-0125111210.1186/s12879-025-11382-8HEV seroprevalence and associated risk factors among HIV-positive individuals in post-earthquake Kathmandu: a 2016 cross-sectional studyChandramani Wagle0Jagat Bahadur Baniya1Nirmal Aryal2Dinesh Prasad Ghimire3Ajay Kumar Sah4Abhay Kumar Sah5Vivek Prasad Gupta6Birendra Prasad Gupta7Global Clinical ResearchVirology Society NepalVirology Society NepalVirology Society NepalGlobal Clinical ResearchVirology Society NepalVirology Society NepalVirology Society NepalAbstract Introduction Hepatitis E virus (HEV) infection poses a significant public health challenge, particularly in immunocompromised populations such as those living with HIV. Limited data exist on HEV seroprevalence and its correlates among HIV-positive individuals in urban low-resource settings, especially in the aftermath of disasters. This study investigates HEV seroprevalence and risk factors among HIV positive individuals in 2016, a post-earthquake period in Kathmandu, Nepal, with relevance to ongoing challenges in 2025. Methods We conducted a cross-sectional serological study among 200 HIV-positive individuals from Sukraraj Tropical and Infectious Disease Hospital’s (STIDH) Antiretroviral Therapy (ART) center in Kathmandu. Serological testing determined anti-HEV IgG and IgM status using Wantai Hepatitis E (HEV-IgG/M) ELISA kits. Sociodemographic, behavioral, and clinical data were collected via structured interviews and medical records. Multivariable logistic regression identified independent predictors of anti-HEV IgG seropositivity. Statistical analyses used Chi-square, Mann-Whitney U, and Cochran’s Q tests, with p < 0.05 considered significant. A comparative general population sample (n = 100) from earthquake-affected districts was also analyzed. Results Overall, 43.5% (87/200) of HIV-positive participants tested positive for anti-HEV IgG. Key demographic predictors included increasing age, which showed a significant non-linear association (adjusted OR = 3.95 for age, 0.60 for age²; p < 0.001), and a marginal association with male gender (aOR = 2.03; p = 0.059). In contrast, no significant associations were observed between HEV seropositivity and specific drinking water sources, water processing methods, eating habits, smoking status, CD4 count, HIV viral load suppression, common comorbidities, or routine liver and hematological markers. anti-HEV IgG seroprevalence was considerably higher than that of Hepatitis B virus (4.5%) and Hepatitis C virus (5.0%) in the cohort and notably absent in a comparative general population sample. The predictive model showed good performance (AUC = 0.80), supporting its exploratory utility. Conclusion Our findings reveal a high burden of past HEV exposure among HIV-positive individuals in post-earthquake Kathmandu, with age being a key correlate. The absence of HEV IgG positivity in the general population sample suggests that HEV exposure during this period may have been localized to vulnerable clinical groups. The lack of association with traditional behavioral or clinical markers highlights the complexity of transmission in this setting. These results underscore the need to integrate HEV awareness and targeted screening into HIV care in endemic regions. Future studies should prioritize longitudinal follow-up, genotype surveillance, and environmental sampling to inform public health preparedness and response.https://doi.org/10.1186/s12879-025-11382-8Hepatitis E virus (HEV)HIV-positiveSeroprevalenceKathmanduPost-earthquake |
| spellingShingle | Chandramani Wagle Jagat Bahadur Baniya Nirmal Aryal Dinesh Prasad Ghimire Ajay Kumar Sah Abhay Kumar Sah Vivek Prasad Gupta Birendra Prasad Gupta HEV seroprevalence and associated risk factors among HIV-positive individuals in post-earthquake Kathmandu: a 2016 cross-sectional study BMC Infectious Diseases Hepatitis E virus (HEV) HIV-positive Seroprevalence Kathmandu Post-earthquake |
| title | HEV seroprevalence and associated risk factors among HIV-positive individuals in post-earthquake Kathmandu: a 2016 cross-sectional study |
| title_full | HEV seroprevalence and associated risk factors among HIV-positive individuals in post-earthquake Kathmandu: a 2016 cross-sectional study |
| title_fullStr | HEV seroprevalence and associated risk factors among HIV-positive individuals in post-earthquake Kathmandu: a 2016 cross-sectional study |
| title_full_unstemmed | HEV seroprevalence and associated risk factors among HIV-positive individuals in post-earthquake Kathmandu: a 2016 cross-sectional study |
| title_short | HEV seroprevalence and associated risk factors among HIV-positive individuals in post-earthquake Kathmandu: a 2016 cross-sectional study |
| title_sort | hev seroprevalence and associated risk factors among hiv positive individuals in post earthquake kathmandu a 2016 cross sectional study |
| topic | Hepatitis E virus (HEV) HIV-positive Seroprevalence Kathmandu Post-earthquake |
| url | https://doi.org/10.1186/s12879-025-11382-8 |
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