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Hepatitis E virus and the kidney in solid-organ transplant patients.
Transplantation. 2012 Mar 27; 93(6):617-23.T

Abstract

BACKGROUND

Hepatitis E virus (HEV) infection is an emerging disease in industrialized countries. Few data regarding genotype 3 HEV extrahepatic manifestations exist.

METHODS

We assessed kidney function and histology in solid-organ transplant patients during HEV infection. In all, 51 cases of genotype 3 HEV infections were diagnosed (34 kidney, 14 liver, and 3 kidney-pancreas transplant patients). Of these, 43.2% were cleared of the virus spontaneously within 6 months of infection, whereas 56.8% evolved to chronic hepatitis. Twelve of these patients completed a 3-month antiviral therapy and were followed up for 6 months posttreatment. Kidney function (estimated glomerular filtration rate [eGFR] obtained by the Modification of Diet in Renal Disease equation) and proteinuria were assessed before infection, during HEV infection and during follow-up. Kidney biopsies were obtained from patients with high proteinuria and decreased eGFR levels.

RESULTS

During HEV infection, there was a significant decrease in eGFR in both kidney- and liver-transplant patients. Glomerular diseases were observed in kidney biopsies obtained during the acute and chronic phases. This included membranoproliferative glomerulonephritis and relapses in IgA nephropathy. The majority of patients had cryoglobulinemia that became negative after HEV clearance. Kidney function improved and proteinuria decreased after HEV clearance.

CONCLUSION

HEV-associated glomerulonephritis seems to be an HEV-related extrahepatic manifestation. Further studies are required to confirm these observations.

Authors+Show Affiliations

Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, Toulouse, France. kamar.n@chu-toulouse.frNo 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 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

22298032

Citation

Kamar, Nassim, et al. "Hepatitis E Virus and the Kidney in Solid-organ Transplant Patients." Transplantation, vol. 93, no. 6, 2012, pp. 617-23.
Kamar N, Weclawiak H, Guilbeau-Frugier C, et al. Hepatitis E virus and the kidney in solid-organ transplant patients. Transplantation. 2012;93(6):617-23.
Kamar, N., Weclawiak, H., Guilbeau-Frugier, C., Legrand-Abravanel, F., Cointault, O., Ribes, D., Esposito, L., Cardeau-Desangles, I., Guitard, J., Sallusto, F., Muscari, F., Peron, J. M., Alric, L., Izopet, J., & Rostaing, L. (2012). Hepatitis E virus and the kidney in solid-organ transplant patients. Transplantation, 93(6), 617-23. https://doi.org/10.1097/TP.0b013e318245f14c
Kamar N, et al. Hepatitis E Virus and the Kidney in Solid-organ Transplant Patients. Transplantation. 2012 Mar 27;93(6):617-23. PubMed PMID: 22298032.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hepatitis E virus and the kidney in solid-organ transplant patients. AU - Kamar,Nassim, AU - Weclawiak,Hugo, AU - Guilbeau-Frugier,Céline, AU - Legrand-Abravanel,Florence, AU - Cointault,Olivier, AU - Ribes,David, AU - Esposito,Laure, AU - Cardeau-Desangles,Isabelle, AU - Guitard,Joelle, AU - Sallusto,Federico, AU - Muscari,Fabrice, AU - Peron,Jean Marie, AU - Alric,Laurent, AU - Izopet,Jacques, AU - Rostaing,Lionel, PY - 2012/2/3/entrez PY - 2012/2/3/pubmed PY - 2012/5/2/medline SP - 617 EP - 23 JF - Transplantation JO - Transplantation VL - 93 IS - 6 N2 - BACKGROUND: Hepatitis E virus (HEV) infection is an emerging disease in industrialized countries. Few data regarding genotype 3 HEV extrahepatic manifestations exist. METHODS: We assessed kidney function and histology in solid-organ transplant patients during HEV infection. In all, 51 cases of genotype 3 HEV infections were diagnosed (34 kidney, 14 liver, and 3 kidney-pancreas transplant patients). Of these, 43.2% were cleared of the virus spontaneously within 6 months of infection, whereas 56.8% evolved to chronic hepatitis. Twelve of these patients completed a 3-month antiviral therapy and were followed up for 6 months posttreatment. Kidney function (estimated glomerular filtration rate [eGFR] obtained by the Modification of Diet in Renal Disease equation) and proteinuria were assessed before infection, during HEV infection and during follow-up. Kidney biopsies were obtained from patients with high proteinuria and decreased eGFR levels. RESULTS: During HEV infection, there was a significant decrease in eGFR in both kidney- and liver-transplant patients. Glomerular diseases were observed in kidney biopsies obtained during the acute and chronic phases. This included membranoproliferative glomerulonephritis and relapses in IgA nephropathy. The majority of patients had cryoglobulinemia that became negative after HEV clearance. Kidney function improved and proteinuria decreased after HEV clearance. CONCLUSION: HEV-associated glomerulonephritis seems to be an HEV-related extrahepatic manifestation. Further studies are required to confirm these observations. SN - 1534-6080 UR - https://www.unboundmedicine.com/medline/citation/22298032/Hepatitis_E_virus_and_the_kidney_in_solid_organ_transplant_patients_ L2 - https://doi.org/10.1097/TP.0b013e318245f14c DB - PRIME DP - Unbound Medicine ER -