Genotype 4 hepatitis E virus is a cause of chronic hepatitis in renal transplant recipients in Hong Kong

Sridhar, Siddharth; Chan, Jasper Fuk‐Woo; Yap, Desmond Y H; Teng, Jade L. L.; Huang, Chuiguo; Yip, Cyril Chik-Yan; Hung, Ivan Fan-Ngai; Tang, Sydney C.W.; Lau, Susanna K.P.; Woo, Patrick C. Y.; Yuen, Kwok‐Yung

doi:10.1111/jvh.12799

Cited by 31 publications

(32 citation statements)

References 8 publications

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“…The current decade has seen blood transfusion as a route of HEV transmission in the immunocompromised as well as immune competent patients. Till recently, HEV genotype 3 was the sole cause of chronic infection in organ transplants, but with the very recent report that HEV genotype 4 can also cause chronic hepatitis in transplant recipients, HEV becomes a virus of emerging importance to vulnerable transfusion recipients . Despite the high prevalence, high rate of transmission by HEV infected blood or blood products and narrow range of HEV‐specific efficient antiviral therapy, factors like associated low level of morbidity, mortality, and economic benefit of donation screening have resulted in implementation of HEV screening only in the developed countries like United Kingdom, Ireland and the Netherlands …”

Section: Discussionmentioning

confidence: 99%

“…Till date, chronic HEV infection with genotype 3 had been documented in solid organ transplant and blood transfusion recipients . A very recent report has documented that HEV genotype 4 can cause chronic hepatitis in solid organ transplant recipients . There are reports of transfusion‐transmitted HEV infections in several countries and also detection of HEV in human blood products …”

Section: Introductionmentioning

confidence: 99%

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Hepatitis E virus seroprevalence among blood donors in Pune, India

Tripathy

Puranik

Sharma

et al. 2018

Journal of Medical Virology

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Background Blood transfusion is a recently reported route of hepatitis E virus (HEV) transmission. It is a bigger concern in regions where large‐scale HEV genotype 1 infections occur causing more severe disease. The present study aims to assess the prevalence and rate of HEV infection in the blood donors of Pune, India. Materials and Methods A total of 2447 healthy blood donors were screened for anti‐HEV IgG and IgM antibodies. Anti‐HEV IgM antibody positives were further subjected to alanine aminotransferase measurement, HEV RNA detection, viral load quantification and phylogenetic analysis. Results Anti‐HEV seroprevalence rate was 17.70%, while IgM prevalence rate was 0.20%. An age dependent increase in IgG seropositive rate was observed. Two of five IgM‐positives tested positive for HEV RNA. The viral load ranged from 3.5 × 104 to 4.6 × 105 copies/mL and belonged to HEV genotype 1. Conclusions HEV prevalence rate of 17.70% in the blood donors of Pune, India, a developing country, goes at par with the developed countries. Current data of 0.20% (5 of 2447) blood donors positive for anti‐HEV IgM and two of them being HEV RNA positive suggest a need for consideration of cost‐effective evaluation towards pooled HEV RNA testing in blood banks.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hepatitis E virus seroprevalence among blood donors in Pune, India

Tripathy

Puranik

Sharma

et al. 2018

Journal of Medical Virology

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“…Chronic infections by HEV‐3 and HEV‐4 have been identified among immunocompromised persons worldwide, including organ transplant recipients, patients receiving cancer chemotherapy and HIV‐infected persons …”

Section: Detection Of Hev In Humans In South Americamentioning

confidence: 99%

Hepatitis E virus in South America: The current scenario

Pisano

Martinez‐Wassaf²,

Mirazo

et al. 2018

Liver International

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Hepatitis E virus (HEV) is one of the most frequent causes of acute viral hepatitis of enteric transmission worldwide. In South America the overall epidemiology has been little studied, and the burden of the disease remains largely unknown. A research of all scientific articles about HEV circulation in South America until November 2017 was carried out. Human seroprevalences of HEV varied according to the studied population: blood donors presented prevalence rates ranging from 1.8% to 9.8%, while reports from HIV‐infected individuals, transplant recipients and patients on hemodialysis showed higher prevalence rates. Only 2 cases of chronic hepatitis in solid‐organ transplant patients from Argentina and Brazil have been described. Detection of HEV in the swine population is widely prevalent in the region. Anti‐HEV antibodies have also been recently documented in wild boars from Uruguay. Although scarce, studies focused on environmental and food HEV detection have shown viral presence in these kind of samples, highlighting possible transmission sources of HEV in the continent. HEV genotype 3 was the most frequently detected in the region, with HEV genotype 1 detected only in Venezuela and Uruguay. HEV is widely distributed throughout South America, producing sporadic cases of acute hepatitis, but as a possible agent of chronic hepatitis. Finding the virus in humans, animals, environmental samples and food, show that it can be transmitted through many sources, alerting local governments and health systems to improve diagnosis and for the implementation of preventive measures.

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“…Reported cases of chronic infection to date are in G3 and G4, but not G1 as in our case [ 5 ]. It has been reported following renal [ 6 ], heart and lung transplantation [ 7 ] and blood products for solid organ transplant recipients are now required to be hepatitis E negative in the UK [ 8 ]. HIV is also a risk factor [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Chronic genotype 1 hepatitis E infection from immunosuppression for ileo-colonic Crohn’s disease

Robins

Bowden

Gelson

2018

Oxford Medical Case Reports

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We report a case of a 33-year-old man with a background of longstanding ileo-colonic Crohn’s disease and primary sclerosing cholangitis. Following a trip to India he developed diarrhoea which was treated as an exacerbation of Crohn’s disease. Liver tests became chronically deranged after increasing immunosuppression, which comprised mercaptopurine, adalimumab and prednisolone. Chronic genotype 1 hepatitis E was diagnosed and successfully treated with reduction of immunosuppression followed by a 24-week course of ribavirin. We believe that this is the first reported case of chronic hepatitis E in genotype 1. Deranged liver tests should prompt testing for hepatitis E infection in the context of immunosuppression for inflammatory bowel disease.

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Genotype 4 hepatitis E virus is a cause of chronic hepatitis in renal transplant recipients in Hong Kong

Cited by 31 publications

References 8 publications

Hepatitis E virus seroprevalence among blood donors in Pune, India

Hepatitis E virus seroprevalence among blood donors in Pune, India

Hepatitis E virus in South America: The current scenario

Chronic genotype 1 hepatitis E infection from immunosuppression for ileo-colonic Crohn’s disease

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