Background. The aim of this study was to determine the prevalence of h
epatitis E virus (HEV) infection among patients undergoing haemodialys
is (HD) and to evaluate whether chronic haemodialysis is associated wi
th an increased risk of HEV infection. Methods. Serum samples from 420
HD patients and 316 healthy volunteers were tested for IgG and IgM an
tibodies to HEV (anti-HEV). Anti-HEV testing was done by an enzyme imm
unoassay (EIA) based on recombinant proteins of HEV (Abbott Labs). All
anti-HEV IgG positive sera were continued using synthetic peptides. R
esults. Anti-HEV IgG was confirmed in 27/420 (6.4%) of the HD patients
and in 7/316 (2.2%) of the reference group (P=0.007). However, multip
le logistic regression analysis showed that the prevalence of anti-HEV
IgG was not significantly higher in HD patients compared with the ref
erence group, after controlling for age and sex. No patient was found
positive for anti-HEV IgM. The presence of anti-HEV was associated wit
h sex in HD patients (P=0.04). No significant association was found be
tween anti-HEV and underlying renal disease, anti-HCV, anti-HBc, blood
transfusions, history of elevated transaminases, history of clinical
hepatitis and renal transplantation. A marginal association, which was
observed with the duration of haemodialysis in univariate analysis (P
=0.07), was not confirmed in multivariate analysis. Conclusions. Chron
ic haemodialysis is not associated with an increased risk of exposure
to HEV, and the high prevalence of anti-HEV IgG in HD patients reporte
d in uncontrolled studies is possibly due to the confounding effect of
age and sex.