A Nationwide Survey of Hepatitis E Virus Infection and Chronic Hepatitis in Heart and Kidney Transplant Recipients in Japan
A Nationwide Survey of Hepatitis E Virus Infection and Chronic Hepatitis in Heart and Kidney Transplant Recipients in Japan
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DOI：
10.1097/tp.0000000000002801
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发表时间：
2020-02-01
期刊：
影响因子：
6.2
通讯作者：
Ohkohchi, Nobuhiro
中科院分区：
文献类型：
--
作者：
Owada, Yohei;Oshiro, Yukio;Ohkohchi, Nobuhiro
背景：最近，在欧洲国家的实体器官移植（SOT）受者中有慢性戊型肝炎的报道。以前，我们阐明了戊型肝炎病毒（HEV）感染在日本肝移植受者中的流行情况，并确定了2例因输血感染的慢性戊型肝炎患者。然而，在日本，除肝脏外的SOT接受者的HEV感染率仍不清楚，因此，我们进行了一项全国性的调查，以澄清日本心脏和肾移植受者中慢性HEV感染的流行情况。方法：在日本17家医院，共检查了99名心脏和2526名肾移植受者的IgG类抗-HEV抗体的存在。结果：心、肾移植受者抗-HEVIgG阳性率分别为7.07%（7/99）和4.08%（103/2526）。1例心脏移植患者（1.01%）和11例肾移植患者（0.44%）检出HEVRNA。所有病毒血症患者的HEV分离株均被分型为基因型3。4例患者在移植后发生慢性戊型肝炎。三名患者用利巴韦林治疗，他们的肝酶正常化，HEV RNA立即变为阴性。持续的病毒学反应，在所有cases.Conclusions。这是第一次在日本心脏和肾移植受者的HEV感染的全国性调查。日本心脏和肾移植受者中抗-HEVIgG和HEVRNA的流行率低于欧洲国家。值得注意的是，42%的病毒血症移植患者发展为慢性肝炎。
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.