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Hepatitis E virus excretion can be prolonged in patients with hematological malignancies.
J Clin Virol. 2010 Oct; 49(2):141-4.JC

Abstract

BACKGROUND

Hepatitis E virus (HEV) is transmitted via the fecal-oral route and locally acquired sporadic hepatitis E can occur in Western countries. Chronic hepatitis E virus infections have been recently described in solid organ transplant recipients. There is little data on the evolution of hepatitis E in patients immunocompromised for other reasons.

OBJECTIVES

The aim of this study was to evaluate the clinical course of hepatitis E in patients immunocompromised because of hematological malignancies.

STUDY DESIGN

Starting on November 2003, all patients in the Toulouse University Hospital Hematology Department with unexplained elevated transaminases were tested for hepatitis E using viral RNA detection in serum or stools and serology.

RESULTS

Acute hepatitis E was diagnosed in six middle-aged hematology patients. All cases were autochthonous. HEV strains were genotype 3. All patients had a significant increase of transaminases (6-95 upper limit normal) and only two had HEV IgG. Five patients were asymptomatic and one had jaundice. Transmission of HEV occurred between two patients who had overlapping stays in the hematology ward. All five evaluable patients ultimately cleared their HEV but viremia was prolonged over 6 months in three patients and specific treatment had to be postponed in two patients.

CONCLUSION

Screening for HEV should be carried out routinely in hematology patients with elevated transaminases, and patient-to-patient transmission is a concern. Further studies are required to determine whether management of malignancy, particularly stem-cell transplantation should be adapted to HEV status.

Authors+Show Affiliations

Service d'Hématologie, CHU de Toulouse, Hôpital Purpan, Place du Dr Baylac, 31059 Toulouse cedex, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

20678959

Citation

Tavitian, Suzanne, et al. "Hepatitis E Virus Excretion Can Be Prolonged in Patients With Hematological Malignancies." Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology, vol. 49, no. 2, 2010, pp. 141-4.
Tavitian S, Péron JM, Huynh A, et al. Hepatitis E virus excretion can be prolonged in patients with hematological malignancies. J Clin Virol. 2010;49(2):141-4.
Tavitian, S., Péron, J. M., Huynh, A., Mansuy, J. M., Ysebaert, L., Huguet, F., Vinel, J. P., Attal, M., Izopet, J., & Récher, C. (2010). Hepatitis E virus excretion can be prolonged in patients with hematological malignancies. Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology, 49(2), 141-4. https://doi.org/10.1016/j.jcv.2010.06.016
Tavitian S, et al. Hepatitis E Virus Excretion Can Be Prolonged in Patients With Hematological Malignancies. J Clin Virol. 2010;49(2):141-4. PubMed PMID: 20678959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hepatitis E virus excretion can be prolonged in patients with hematological malignancies. AU - Tavitian,Suzanne, AU - Péron,Jean-Marie, AU - Huynh,Anne, AU - Mansuy,Jean-Michel, AU - Ysebaert,Loic, AU - Huguet,Françoise, AU - Vinel,Jean-Pierre, AU - Attal,Michel, AU - Izopet,Jacques, AU - Récher,Christian, Y1 - 2010/08/01/ PY - 2010/02/04/received PY - 2010/06/21/revised PY - 2010/06/29/accepted PY - 2010/8/4/entrez PY - 2010/8/4/pubmed PY - 2011/1/5/medline SP - 141 EP - 4 JF - Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology JO - J Clin Virol VL - 49 IS - 2 N2 - BACKGROUND: Hepatitis E virus (HEV) is transmitted via the fecal-oral route and locally acquired sporadic hepatitis E can occur in Western countries. Chronic hepatitis E virus infections have been recently described in solid organ transplant recipients. There is little data on the evolution of hepatitis E in patients immunocompromised for other reasons. OBJECTIVES: The aim of this study was to evaluate the clinical course of hepatitis E in patients immunocompromised because of hematological malignancies. STUDY DESIGN: Starting on November 2003, all patients in the Toulouse University Hospital Hematology Department with unexplained elevated transaminases were tested for hepatitis E using viral RNA detection in serum or stools and serology. RESULTS: Acute hepatitis E was diagnosed in six middle-aged hematology patients. All cases were autochthonous. HEV strains were genotype 3. All patients had a significant increase of transaminases (6-95 upper limit normal) and only two had HEV IgG. Five patients were asymptomatic and one had jaundice. Transmission of HEV occurred between two patients who had overlapping stays in the hematology ward. All five evaluable patients ultimately cleared their HEV but viremia was prolonged over 6 months in three patients and specific treatment had to be postponed in two patients. CONCLUSION: Screening for HEV should be carried out routinely in hematology patients with elevated transaminases, and patient-to-patient transmission is a concern. Further studies are required to determine whether management of malignancy, particularly stem-cell transplantation should be adapted to HEV status. SN - 1873-5967 UR - https://www.unboundmedicine.com/medline/citation/20678959/Hepatitis_E_virus_excretion_can_be_prolonged_in_patients_with_hematological_malignancies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1386-6532(10)00260-X DB - PRIME DP - Unbound Medicine ER -