Risk factors associated with Hepatitis E virus infection in kidney transplant recipients in a single tertiary Center in the United States

Sakulsaengprapha, Vorada; Wasuwanich, Paul; Thawillarp, Supharerk; Ingviya, Thammasin; Phimphilai, Premporn; Sue, Paul K.; Jackson, Annette M.; Kraus, Edward S.; Teshale, Eyasu H.; Kamili, Saleem; Karnsakul, Wikrom

doi:10.1016/j.trim.2023.101809

Cited by 2 publications

(1 citation statement)

References 20 publications

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“…Nutritional advice during patient care and avoidance of weight loss with the detection of factors associated with cachexia, e.g., undetected inflammation, are important. Along the same line, older age (>60 years) tended to be a risk factor for an unfavorable outcome [ 47 , 48 ]. Moreover, an early viral response to RBV may have an impact on the overall treatment response.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Hepatitis E Virus Infection and Eating Habits in Kidney Transplant Recipients

Koch

Bachmann

et al. 2023

Pathogens

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There is a significant risk for ongoing and treatment-resistant courses of hepatitis E virus (HEV) infection in patients after solid organ transplantation. The aim of this study was to identify risk factors for the development of hepatitis E, including the dietary habits of patients. We conducted a retrospective single-center study with 59 adult kidney and combined kidney transplant recipients who were diagnosed with HEV infection between 2013 and 2020. The outcomes of HEV infections were analyzed during a median follow-up of 4.3 years. Patients were compared with a control cohort of 251 transplant patients with elevated liver enzymes but without evidence of an HEV infection. Patients’ alimentary exposures during the time before disease onset or diagnosis were assessed. Previous intense immunosuppression, especially treatment with high-dose steroids and rituximab, was a significant risk factor to acquire hepatitis E after solid organ transplantation. Only 11 out of 59 (18.6%) patients reached remission without further ribavirin (RBV) treatment. A total of 48 patients were treated with RBV, of which 19 patients (39.6%) had either viral rebounds after the end of treatment or did not reach viral clearance at all. Higher age (>60 years) and a BMI ≤ 20 kg/m2 were risk factors for RBV treatment failure. Deterioration in kidney function with a drop in eGFR (p = 0.046) and a rise in proteinuria was more common in patients with persistent hepatitis E viremia. HEV infection was associated with the consumption of undercooked pork or pork products prior to infection. Patients also reported processing raw meat with bare hands at home more frequently than the controls. Overall, we showed that the intensity of immunosuppression, higher age, a low BMI and the consumption of undercooked pork meat correlated with the development of hepatitis E.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Hepatitis E Virus Infection and Eating Habits in Kidney Transplant Recipients

Koch

Bachmann

et al. 2023

Pathogens

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Hepatitis E Vaccines Updates

Hartley,

Wasuwanich,

Van

et al. 2024

Vaccines

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The development of a hepatitis E vaccine is imperative given its prevalence and the heightened risk it poses to specific populations. Hepatitis E virus infection, though often self-limiting, poses a significant threat to pregnant individuals and immunocompromised populations. This review delves into the historical trajectory of hepatitis E vaccine development and explores its potential impact on at-risk populations. Historically, efforts to formulate an effective vaccine against hepatitis E have been underway to mitigate the severity of the disease, particularly in regions where the infection is commonplace. As a self-limiting disease, the necessity of a vaccine becomes more pronounced when considering vulnerable demographics. Pregnant individuals face heightened complications, with potential adverse outcomes for both mother and child. Similarly, immunocompromised individuals experience prolonged and severe manifestations of the infection, necessitating targeted preventive measures. This review aims to provide a comprehensive overview of the milestones in hepatitis E vaccine development. By examining the historical progression, we aim to underscore the critical need for a vaccine to safeguard not only the general population but also those at elevated risk. The elucidation of the vaccine’s journey will contribute valuable insights into its potential benefits, aiding in the formulation of informed public health strategies to combat hepatitis E effectively.

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Risk factors associated with Hepatitis E virus infection in kidney transplant recipients in a single tertiary Center in the United States

Cited by 2 publications

References 20 publications

Risk Factors for Hepatitis E Virus Infection and Eating Habits in Kidney Transplant Recipients

Risk Factors for Hepatitis E Virus Infection and Eating Habits in Kidney Transplant Recipients

Hepatitis E Vaccines Updates

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