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J Infect Dis. 2014 Jun 15;209(12):1900-6. doi: 10.1093/infdis/jiu032. Epub 2014 Jan 16.

Hepatitis E virus reinfections in solid-organ-transplant recipients can evolve into chronic infections.

Author information

1
Centre de Physiopathologie de Toulouse Purpan, INSERM U1043 National Reference Center for Hepatitis E, Laboratoire de virologie, Institut fédératif de biologie, Hôpital Purpan.
2
National Reference Center for Hepatitis E, Laboratoire de virologie, Institut fédératif de biologie, Hôpital Purpan.
3
Service de chirurgie viscérale et digestive, Hôpital Rangueil, CHU Toulouse, France.
4
Service de Néphrologie, Dialyse et Transplantation multi-organe.
5
Centre de Physiopathologie de Toulouse Purpan, INSERM U1043 Service de Néphrologie, Dialyse et Transplantation multi-organe.

Abstract

BACKGROUND:

Hepatitis E virus (HEV) infections are a major cause of acute hepatitis in developing and industrialized countries. Little is known about anti-HEV immunity in solid-organ recipients.

METHODS:

We screened 263 solid-organ recipients for anti-HEV immunoglobulin G (IgG) at transplantation. They were followed up for 1 year and tested for HEV RNA and anti-HEV antibodies 1 year after transplantation and if their liver enzyme activities increased.

RESULTS:

A total of 38.4% had anti-HEV IgG at transplantation. The mean concentrations (±SD) of anti-HEV IgG at transplantation (8 ± 17.5 U/mL) and 1 year later (6.4 ± 12.0 U/mL, P = .4) were similar. There were 3 de novo HEV infections during the 1-year follow-up among patients who were HEV seronegative before transplantation, giving an annual incidence of 2.1%. We also identified 3 HEV reinfections among patients who were seropositive before transplantation through detection of HEV RNA, for an annual incidence of 3.3%. Their anti-HEV IgG concentrations were 0.3, 2.1, and 6.2 World Health Organization (WHO) units/mL before transplantation. Reinfection of the patient with the lowest IgG concentration at transplantation had evolved to a chronic infection.

CONCLUSIONS:

Low anti-HEV antibodies (<7 WHO units/mL) seemed not to protect solid-organ recipients. HEV reinfection in immunocompromised patients can lead to chronic infection, as in primary infections.

KEYWORDS:

Hepatitis E virus; incidence; reinfection; solid organ transplant recipients

PMID:
24436450
DOI:
10.1093/infdis/jiu032
[Indexed for MEDLINE]

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