The spontaneous clearance of hepatitis E virus (HEV) and emergence of HEV antibodies in a transfusion-transmitted chronic hepatitis E case after completion of chemotherapy for acute myeloid leukemia
The spontaneous clearance of hepatitis E virus (HEV) and emergence of HEV antibodies in a transfusion-transmitted chronic hepatitis E case after completion of chemotherapy for acute myeloid leukemia
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急性髓性白血病化疗结束后输血传播的慢性戊型肝炎病例中戊型肝炎病毒（HEV）的自发清除和HEV抗体的出现
DOI：
10.1007/s12328-019-01024-3
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发表时间：
2020
影响因子：
1
通讯作者：
et al.
中科院分区：
文献类型：
--
作者：
Okano H;Nakano T;Ito R;Tanaka A;Hoshi Y;Matsubayashi K;Asakawa H;Nose K;Tsuruga S;Tochio T;Kumazawa H;Isono Y;Tanaka H;Matsusaki S;Sase T;Saito T;Mukai K;Nishimura A;Kawakami K;Nagashima S;et al.
一名64岁的妇女在白血病化疗期间感染了戊型肝炎病毒（HEV）。通过对血液制品和患者储存血清的回顾性分析，确定感染的来源是化疗期间输注的血小板浓度（PC）。从供者PC中分离的HEV株与从患者血清中分离的HEV株部分核苷酸序列完全相同，均为3b亚型。从感染开始至终止感染后1年，检测血清丙氨酸氨基转移酶（ALT）、HEVRNA滴度和抗-HEV抗体。HEVRNA在化疗后6个月内增殖，然后在化疗结束后自发清除。血清中抗HEV抗体在HEV RNA清除前出现。有趣的是，在患者的尿液、脊髓液和唾液中检测到了HEV RNA。这些样品中的HEV RNA滴度远低于血清和粪便中的HEV RNA滴度。随访期间未出现肾脏、神经系统或唾液腺疾病。我们观察了病毒学和生化进展和治愈输血传播的慢性戊型肝炎的患者，尽管免疫抑制状态期间和化疗后对血液系统恶性肿瘤。
A 64-year-old woman was infected with hepatitis E virus (HEV) during chemotherapy for leukemia. By retrospective analyses of stored serum from the blood products and the patient, the source of the infection was determined to be platelet concentration (PC) transfused during chemotherapy. The partial nucleotide sequence of the HEV strain isolated from the donated PC and that from the patient’s sera was identical and was subgenotype 3b. Clinical indicators such as alanine aminotransferase, HEV RNA titer, and anti-HEV antibodies in the serum were investigated from the beginning of the infection until 1 year after the termination of HEV infection. HEV RNA had propagated over 6 months and then cleared spontaneously after the completion of chemotherapy. Anti-HEV antibodies appeared in the serum just before the clearance of HEV RNA. Interestingly, HEV RNA was detected in the patient’s urine, spinal fluid, and saliva. The HEV RNA titers in those samples were much lower than in the serum and feces. No renal, neurological, or salivary gland disorders appeared during the follow-up. We observed virological and biochemical progress and cure of transfusion-transmitted chronic hepatitis E in the patient despite an immunosuppressive status during and after chemotherapy against hematological malignancy.