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Saudi J Gastroenterol. 2018 Aug 14. doi: 10.4103/sjg.SJG_230_18. [Epub ahead of print]

In-hospital post-transplant acute hepatitis A viral (HAV) infection in a liver transplant recipient who was HAV seropositive pre-transplant.

Author information

1
Division of Gastroenterology, University of British Columbia and the Liver Transplant Program, Vancouver General Hospital, Vancouver, Canada.
2
Faculty of Pharmaceutical Sciences, University of British Columbia and the Liver Transplant Program, Vancouver General Hospital, Vancouver, Canada.
3
BC Centre for Disease Control, University of British Columbia and the Liver Transplant Program, Vancouver General Hospital, Vancouver, Canada.
4
Department of Pathology and Laboratory Medicine, University of British Columbia and the Liver Transplant Program, Vancouver General Hospital, Vancouver, Canada.

Abstract

Acute hepatitis A viral (HAV) infection is rare in the liver transplant population due to recommended pre-transplant vaccinations. We report a case of acute hepatitis A infection in a liver transplant recipient. This individual had immunity to hepatitis A with protective IgG antibodies and presented with abnormal liver biochemistry in the post-transplant in-patient setting. Hepatitis A infection was confirmed by positive HAV IgM whereas other etiologies, including acute cellular rejection, were ruled out by laboratory tests and liver biopsies. He was treated conservatively with supportive care and liver enzymes recovered to normal baseline. Despite adequate pre-transplant immunity, in the post-transplant setting there may be loss of protective immunity due to profound immunosuppression and hence hepatitis A should remain an important differential diagnosis in the setting of acute hepatitis.

KEYWORDS:

Acute hepatitis; hepatitis A vaccination; hepatitis A viral infection; immunosuppression; liver transplant

PMID:
30117491
DOI:
10.4103/sjg.SJG_230_18
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