Prevalence of Hepatitis E Virus Infection in Liver Transplant Recipients
Prevalence of Hepatitis E Virus Infection in Liver Transplant Recipients
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DOI：
10.1002/lt.21819
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发表时间：
2009-10-01
影响因子：
4.6
通讯作者：
Koopmans, Marion P. G.
中科院分区：
文献类型：
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作者：
Haagsma, Elizabeth B.;Niesters, Hubert G. M.;Koopmans, Marion P. G.
众所周知，戊型肝炎病毒 (HEV) 感染具有自限性。最近，在一些实体器官移植后免疫抑制的患者中发现了慢性戊型肝炎。然而，移植后 HEV 感染的流行情况尚不清楚。我们在 285 名成年肝移植受者的队列中研究了 HEV 参数 [通过酶联免疫吸附测定和验证性免疫印迹法检测 HEV RNA、HEV 免疫球蛋白 M (IgM) 和 HEV 免疫球蛋白 G (IgG)]。对最近冷冻保存的血清进行了研究，如果呈阳性，则进行回顾性分析。 274 名患者 (96.1%) 的样本所有 HEV 参数检测均为阴性。其中包括先前描述的一名过去曾经历过慢性 HEV 肝炎发作的患者。一名患者被发现 HEV RNA 呈阳性，但没有 HEV 抗体。她目前患有慢性HEV 肝炎，之前也有过描述。 9 名患者的血清检测结果呈 HEV IgG 阳性，不含 HEV IgM 或 HEV RNA。回顾起来，这 9 名患者中有 6 名（占总数的 2.1%）被发现具有与移植前某个时间的 HEV 感染相关的 HEV IgG 抗体，因为他们在移植前血清样本中也检测出阳性。根据HEV RNA、IgM和IgG、转氨酶和肝脏组织学的病程回顾，这9例患者中有1例在肝移植后2至5年内患有慢性HEV感染并伴有轻度肝炎。总体而言，该队列中肝移植后获得性 HEV 肝炎的患病率为 1%。我们的结论是，肝移植受者有慢性 HEV 感染的风险，但患病率较低。肝脏移植 15：1225-1228，2009。(C) 2009 AASLD。
Hepatitis E virus (HEV) infection is known to run a self-limited course. Recently, chronic hepatitis E has been described in several immunosuppressed patients after solid organ transplantation. The prevalence of HEV infection after transplantation, however, is unknown. We studied HEV parameters [HEV RNA, HEV immunoglobulin M (IgM), and HEV immunoglobulin G (IgG) by enzyme-linked immunosorbent assay and confirmatory immunoblotting] in a cohort of 285 adult liver transplant recipients. The most recent freeze-stored sera were investigated, and if they were positive, a retrospective analysis was performed. Samples from 274 patients (96.1%) tested negative for all HEV parameters. This included a patient described earlier as having experienced an episode of chronic HEV hepatitis in the past. One patient was found positive for HEV RNA without HEV antibodies. She presently suffers from chronic HEV hepatitis and has also been described before. Sera from 9 patients tested positive for HEV IgG without HEV IgM or HEV RNA. Six of these 9 patients (2.1% of the total) were found to have HEV IgG antibodies in retrospect related to an HEV infection at some time pre-transplant as they also tested positive in a pretransplant serum sample. One of these 9 patients suffered in retrospect from a chronic HEV infection with mild hepatitis between 2 and 5 years after liver transplantation on the basis of the course of HEV RNA, IgM, and IgG, aminotransferases, and liver histology. Overall, the prevalence of acquired HEV hepatitis after liver transplantation was 1% in this cohort. We conclude that liver transplant recipients have a risk for chronic HEV infection, but the prevalence is low. Liver Transpl 15: 1225-1228, 2009. (C) 2009 AASLD.