Hepatitis E Virus and Chronic Hepatitis in Organ-Transplant Recipients

TLDR

HEV is known to cause acute hepatitis that typically does not become chronic. Among 14 acute HEV cases in liver, kidney, and kidney‑pancreas transplant recipients, 8 progressed to chronic hepatitis, all with persistent HEV RNA, and chronic cases had earlier diagnosis and lower lymphocyte and CD2/3/4 T‑cell counts.

Abstract

Hepatitis E virus (HEV) is considered an agent responsible for acute hepatitis that does not progress to chronic hepatitis. We identified 14 cases of acute HEV infection in three patients receiving liver transplants, nine receiving kidney transplants, and two receiving kidney and pancreas transplants. All patients were positive for serum HEV RNA. Chronic hepatitis developed in eight patients, as confirmed by persistently elevated aminotransferase levels, serum HEV RNA, and histologic features of chronic hepatitis. The time from transplantation to diagnosis was significantly shorter and the total counts of lymphocytes and of CD2, CD3, and CD4 T cells were significantly lower in patients in whom chronic disease developed.