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A Nationwide Survey of Hepatitis E Virus Infection and Chronic Hepatitis in Heart and Kidney Transplant Recipients in Japan.
Transplantation. 2020 02; 104(2):437-444.T

Abstract

BACKGROUND

Recently, chronic hepatitis E has been reported in solid organ transplant (SOT) recipients in European countries. Previously, we clarified the prevalence of hepatitis E virus (HEV) infection in Japanese liver transplant recipients and identified 2 chronic hepatitis E patients infected by blood transfusion. However, the rate of HEV infection in recipients of SOTs other than liver in Japan remains unclear, so we conducted a nationwide survey to clarify the prevalence of chronic HEV infection in Japanese heart and kidney transplant recipients.

METHODS

A total of 99 heart and 2526 kidney transplant recipients in 17 hospitals in Japan were examined for the presence of the IgG class of anti-HEV antibodies as well as for serum HEV RNA.

RESULTS

The prevalence of anti-HEV IgG among heart and kidney transplant recipients was 7.07% (7/99) and 4.08% (103/2526), respectively. One heart transplant patient (1.01%) and 11 kidney transplant patients (0.44%) were found to be positive for HEV RNA. The HEV isolates from all viremic patients were typed as genotype 3. Four patients developed chronic hepatitis E after transplantation. Three patients were treated with ribavirin; their liver enzymes normalized, and HEV RNA became negative immediately. Sustained virologic response was achieved in all cases.

CONCLUSIONS

This is the first nationwide survey of HEV infection in Japanese heart and kidney transplant recipients. The prevalence of anti-HEV IgG and HEV RNA in heart and kidney transplant recipients in Japan was lower than that in European countries. Of note, 42% of viremic transplant patients developed chronic hepatitis.

Authors+Show Affiliations

Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.Kidney Transplant Surgery, Sapporo City General Hospital, Chuou-ku, Sapporo, Hokkaido, Japan.Center for Kidney Disease and Transplantation, Akita University Hospital, Akita, Japan.Department of Surgery, JCHO Sendai Hospital, Aoba-ku, Sendai, Miyagi, Japan.Department of Renal Surgery and Transplantation, Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan.Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.Department of Surgery, Chiba-East National Hospital, Chiba, Chiba, Japan.Department of Nephrology, Faculty of Medicine, Toho University, Ota-ku, Tokyo, Japan.Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-ku, Niigata, Japan.Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Showa-ku, Nagoya, Aichi, Japan.Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.Department of Renal Transplantation, Takatsuki General Hospital, Takatsuki, Osaka, Japan.Department of Gastroenterology and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Minami-ku, Hiroshima, Japan.Department of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi, Kochi, Japan.Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan.Department of Cardiovascular Surgery, Kyushu University Faculty of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan.Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan.Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan.Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan.Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan.Department of Transplantation Surgery, National Hospital Organization Mito Medical Center, 280 Sakuranosato Ibarakimachi, Higashiibarakigun, Ibaraki, Japan.Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan.Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31205267

Citation

Owada, Yohei, et al. "A Nationwide Survey of Hepatitis E Virus Infection and Chronic Hepatitis in Heart and Kidney Transplant Recipients in Japan." Transplantation, vol. 104, no. 2, 2020, pp. 437-444.
Owada Y, Oshiro Y, Inagaki Y, et al. A Nationwide Survey of Hepatitis E Virus Infection and Chronic Hepatitis in Heart and Kidney Transplant Recipients in Japan. Transplantation. 2020;104(2):437-444.
Owada, Y., Oshiro, Y., Inagaki, Y., Harada, H., Fujiyama, N., Kawagishi, N., Yagisawa, T., Usui, J., Akutsu, N., Itabashi, Y., Saito, K., Watarai, Y., Ichimaru, N., Imamura, R., Kyakuno, M., Ide, K., Shibuya, Y., Okabe, Y., Ono, M., ... Ohkohchi, N. (2020). A Nationwide Survey of Hepatitis E Virus Infection and Chronic Hepatitis in Heart and Kidney Transplant Recipients in Japan. Transplantation, 104(2), 437-444. https://doi.org/10.1097/TP.0000000000002801
Owada Y, et al. A Nationwide Survey of Hepatitis E Virus Infection and Chronic Hepatitis in Heart and Kidney Transplant Recipients in Japan. Transplantation. 2020;104(2):437-444. PubMed PMID: 31205267.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Nationwide Survey of Hepatitis E Virus Infection and Chronic Hepatitis in Heart and Kidney Transplant Recipients in Japan. AU - Owada,Yohei, AU - Oshiro,Yukio, AU - Inagaki,Yuki, AU - Harada,Hiroshi, AU - Fujiyama,Nobuhiro, AU - Kawagishi,Naoki, AU - Yagisawa,Takashi, AU - Usui,Joichi, AU - Akutsu,Naotake, AU - Itabashi,Yoshihiro, AU - Saito,Kazuhide, AU - Watarai,Yoshihiko, AU - Ichimaru,Naotsugu, AU - Imamura,Ryoichi, AU - Kyakuno,Miyaji, AU - Ide,Kentaro, AU - Shibuya,Yuichi, AU - Okabe,Yasuhiro, AU - Ono,Minoru, AU - Sasaki,Konosuke, AU - Shiose,Akira, AU - Yamagishi,Kazumasa, AU - Ohnishi,Hiroshi, AU - Nagashima,Shigeo, AU - Takahashi,Masaharu, AU - Yuzawa,Kenji, AU - Okamoto,Hiroaki, AU - Ohkohchi,Nobuhiro, PY - 2019/6/18/pubmed PY - 2020/9/30/medline PY - 2019/6/18/entrez SP - 437 EP - 444 JF - Transplantation JO - Transplantation VL - 104 IS - 2 N2 - BACKGROUND: Recently, chronic hepatitis E has been reported in solid organ transplant (SOT) recipients in European countries. Previously, we clarified the prevalence of hepatitis E virus (HEV) infection in Japanese liver transplant recipients and identified 2 chronic hepatitis E patients infected by blood transfusion. However, the rate of HEV infection in recipients of SOTs other than liver in Japan remains unclear, so we conducted a nationwide survey to clarify the prevalence of chronic HEV infection in Japanese heart and kidney transplant recipients. METHODS: A total of 99 heart and 2526 kidney transplant recipients in 17 hospitals in Japan were examined for the presence of the IgG class of anti-HEV antibodies as well as for serum HEV RNA. RESULTS: The prevalence of anti-HEV IgG among heart and kidney transplant recipients was 7.07% (7/99) and 4.08% (103/2526), respectively. One heart transplant patient (1.01%) and 11 kidney transplant patients (0.44%) were found to be positive for HEV RNA. The HEV isolates from all viremic patients were typed as genotype 3. Four patients developed chronic hepatitis E after transplantation. Three patients were treated with ribavirin; their liver enzymes normalized, and HEV RNA became negative immediately. Sustained virologic response was achieved in all cases. CONCLUSIONS: This is the first nationwide survey of HEV infection in Japanese heart and kidney transplant recipients. The prevalence of anti-HEV IgG and HEV RNA in heart and kidney transplant recipients in Japan was lower than that in European countries. Of note, 42% of viremic transplant patients developed chronic hepatitis. SN - 1534-6080 UR - https://www.unboundmedicine.com/medline/citation/31205267/A_Nationwide_Survey_of_Hepatitis_E_Virus_Infection_and_Chronic_Hepatitis_in_Heart_and_Kidney_Transplant_Recipients_in_Japan_ L2 - https://doi.org/10.1097/TP.0000000000002801 DB - PRIME DP - Unbound Medicine ER -