Prevalence and clinical consequences of Hepatitis E in patients who underwent liver transplantation for chronic Hepatitis C in the United States

BMC Infectious Diseases

Research Article

Robert J. de Knegt¹  Ludi Koning²  Annemiek A. van der Eijk³  Suzan D. Pas³  Albert DME Osterhaus³  Michael R. Charlton⁴  Julie K. Heimbach⁵  Kymberly D. Watt⁵  Harry LA Janssen⁶ 

[1] Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands;Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands;Mayo Clinic Transplant Center, Rochester, MN, USA;Department of Viroscience, Erasmus University Medical Center, room NA-1019, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands;Intermountain Medical Center, Transplant Center, Salt Lake City, UT, USA;Mayo Clinic Transplant Center, Rochester, MN, USA;Toronto Centre for Liver Disease, Toronto Western & General Hospital, University Health Network, Toronto, Canada;

关键词: Liver Transplant Recipient;    Solid Organ Transplant Recipient;   

DOI  :  10.1186/s12879-015-1103-9

 received in 2015-01-27, accepted in 2015-08-12,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundInfection with hepatitis E virus (HEV) in immunocompromised patients can lead to severe liver disease. Treatment options for HEV include peginterferon or ribavirin, routinely also used for the treatment of hepatitis C virus (HCV) infection.We determined the prevalence and clinical consequences of HEV in United States (US) based patients who underwent liver transplantation (LT) for chronic HCV.MethodsSeroprevalence of HEV in 145 US LT recipients with a history of chronic HCV was determined pre-LT, 1, 3 and 5 years post-LT. All last available samples and all samples in IgM positive patients and post-LT IgG seroconverters were tested for HEV RNA.ResultsOverall anti-HEV seroprevalence was 42 %. Five patients were HEV IgM positive pre-LT, one patient had IgM seroconversion post-LT and eight patients had IgG seroconversion post-LT. None of the tested samples were positive for HEV RNA. Eight out of nine of the post-LT seroconverters had been treated for HCV recurrence before or at the moment of seroconversion.ConclusionsLT recipients in the US are at risk of acquiring HEV. Post-LT HCV treatment with interferons and/or ribavirin may have protected patients against chronic HEV. With the arrival of new direct antiviral agents for the treatment of HCV and the elimination of peginterferon and ribavirin from HCV treatment regimens, the prevalence of chronic HEV in this population may rise again.

【 授权许可】

CC BY   
© Koning et al. 2015