Hepatitis E virus-related cirrhosis in kidney- and kidney-pancreas-transplant recipients.

TitleHepatitis E virus-related cirrhosis in kidney- and kidney-pancreas-transplant recipients.
Publication TypeJournal Article
Year of Publication2008
AuthorsKamar N, Mansuy J-, Cointault O, Selves J, Abravanel F, Danjoux M, Otal P, Esposito L, Durand D, Izopet J, Rostaing L
JournalAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons//Am J Transplant
Pagination1744 - 8
Date Published2008
ISBN Number1600-6143
Other Numbers100968638
Keywords*Hepatitis E virus/ip [Isolation & Purification], *Hepatitis E/di [Diagnosis], *Liver Cirrhosis/vi [Virology], Adult, Female, Humans, Kidney Transplantation, Liver Function Tests, Male, Middle Aged, Pancreas Transplantation, RNA, Viral

Hepatitis E virus (HEV) infection was thought to be responsible for acute hepatitis that did not become chronic. However, we have recently reported that HEV infection can evolve to chronic hepatitis, at least in solid-organ transplant patients. We report on two cases of rapidly progressive of HEV-related cirrhosis that occurred in two organ-transplant patients. Case 1: A kidney-pancreas-transplant patient developed acute HEV hepatitis 60 months after transplantation, which evolved to chronicity as defined by persisting elevated liver-enzyme levels and positive serum HEV RNA. At 22 months after the acute phase, she presented with cirrhosis and portal hypertension, that is ascites and esophagus varices. Case 2: A kidney-transplant patient developed acute hepatitis 36 months after transplantation, which persisted and remained unexplained for 38 months. Then, HEV RNA was searched for in their serum and stools, and was found to be positive in both. Retrospective analysis of available stored serum, mainly the serum obtained at the acute phase, confirmed the diagnosis of chronic hepatitis E. In both cases, a liver biopsy showed cirrhosis. We conclude that HEV infection cannot only evolve to chronic hepatitis, but can also be responsible for rapidly progressing cirrhosis in organ-transplant patients.

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