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Chronic hepatitis E after solid organ transplantation.
Neth J Med. 2012 Aug; 70(6):261-6.NJ

Abstract

Large outbreaks of acute hepatitis E, caused by hepatitis E virus (HEV) genotypes 1 and 2, are known from developing countries with suboptimal sanitation infrastructure. An increasing incidence of HEV infections is being reported in industrialised countries, caused mainly by HEV genotypes 3 and 4, which are often found among pigs. Recent evidence suggests that in immunocompromised patients about 50% of the cases of acute hepatitis E evolve to chronic hepatitis with rapid progression to cirrhosis. Thus, HEV should be considered a cause of chronic hepatitis in immunocompromised patients, such as solid organ transplant recipients. Because an antibody response to HEV may be absent in these patients, an HEV RNA test should be carried out when serum liver tests are elevated over months. In small case series, ribavirin has been shown to represent a promising treatment option for chronic HEV infection. To increase the awareness for HEV infection in immunocompromised patients, a representative case report of an HEV-infected renal transplant recipient with chronic hepatitis E, successfully treated with ribavirin, is presented. Studies are required to determine the optimal duration of ribavirin therapy and to assess outcome for solid organ transplant recipients with chronic HEV infection.

Authors+Show Affiliations

Departments of Gastroenterology & Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.No 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

22859417

Citation

de Niet, A, et al. "Chronic Hepatitis E After Solid Organ Transplantation." The Netherlands Journal of Medicine, vol. 70, no. 6, 2012, pp. 261-6.
de Niet A, Zaaijer HL, ten Berge I, et al. Chronic hepatitis E after solid organ transplantation. Neth J Med. 2012;70(6):261-6.
de Niet, A., Zaaijer, H. L., ten Berge, I., Weegink, C. J., Reesink, H. W., & Beuers, U. (2012). Chronic hepatitis E after solid organ transplantation. The Netherlands Journal of Medicine, 70(6), 261-6.
de Niet A, et al. Chronic Hepatitis E After Solid Organ Transplantation. Neth J Med. 2012;70(6):261-6. PubMed PMID: 22859417.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic hepatitis E after solid organ transplantation. AU - de Niet,A, AU - Zaaijer,H L, AU - ten Berge,I, AU - Weegink,C J, AU - Reesink,H W, AU - Beuers,U, PY - 2012/8/4/entrez PY - 2012/8/4/pubmed PY - 2016/4/23/medline SP - 261 EP - 6 JF - The Netherlands journal of medicine JO - Neth J Med VL - 70 IS - 6 N2 - Large outbreaks of acute hepatitis E, caused by hepatitis E virus (HEV) genotypes 1 and 2, are known from developing countries with suboptimal sanitation infrastructure. An increasing incidence of HEV infections is being reported in industrialised countries, caused mainly by HEV genotypes 3 and 4, which are often found among pigs. Recent evidence suggests that in immunocompromised patients about 50% of the cases of acute hepatitis E evolve to chronic hepatitis with rapid progression to cirrhosis. Thus, HEV should be considered a cause of chronic hepatitis in immunocompromised patients, such as solid organ transplant recipients. Because an antibody response to HEV may be absent in these patients, an HEV RNA test should be carried out when serum liver tests are elevated over months. In small case series, ribavirin has been shown to represent a promising treatment option for chronic HEV infection. To increase the awareness for HEV infection in immunocompromised patients, a representative case report of an HEV-infected renal transplant recipient with chronic hepatitis E, successfully treated with ribavirin, is presented. Studies are required to determine the optimal duration of ribavirin therapy and to assess outcome for solid organ transplant recipients with chronic HEV infection. SN - 1872-9061 UR - https://www.unboundmedicine.com/medline/citation/22859417/Chronic_hepatitis_E_after_solid_organ_transplantation_ L2 - http://www.njmonline.nl/njm/getarticle.php?v=70&i=6&p=261 DB - PRIME DP - Unbound Medicine ER -