Epidemiology and management of chronic hepatitis E infection in solid organ transplantation: a comprehensive literature review

  title={Epidemiology and management of chronic hepatitis E infection in solid organ transplantation: a comprehensive literature review},
  author={Xinying Zhou and Robert A. de Man and Robert J. Knegt and Herold Johnny Metselaar and Maikel Petrus Peppelenbosch and Qiuwei Pan},
  journal={Reviews in Medical Virology},
Hepatitis E virus (HEV) infection has emerged as a global public health issue. Although it often causes an acute and self‐limiting infection with low mortality rates in the western world, it bears a high risk of developing chronic hepatitis in immunocompromised patients with substantial mortality rates. Organ transplant recipients who receive immunosuppressive medication to prevent rejection are thought to be the main population at risk for chronic hepatitis E. Therefore, there is an urgent… 

Chronic hepatitis E in solid-organ transplantation: the key implications of immunosuppressants

It remains impossible to define an optimal immunosuppressive protocol for these HEV-infected patients, however, the realization of this clinical issue and the initiation of translational research using cell culture models of HEV have been represented as milestones in this field.

HEV and HBV Dual Infection: A Review

  • M. NasirG. Wu
  • Medicine, Biology
    Journal of clinical and translational hepatology
  • 2020
A review of studies on dual infection with HEV and HBV, including the effect of HEV superinfection and coinfection in CHB, management strategies used and the role of active vaccination in the prevention of HEv are appraised.

Chronic Hepatitis E Resolved by Reduced Immunosuppression in Pediatric Kidney Transplant Patients

The course of chronic HEV infection after kidney transplantation in 2 children, who cleared the virus after reduction in immunosuppressive therapy are described.

The global epidemiology of hepatitis E virus infection: A systematic review and meta‐analysis

  • Pengfei LiJiaye Liu Q. Pan
  • Medicine, Biology
    Liver international : official journal of the International Association for the Study of the Liver
  • 2020
This study aims to map the global prevalence and identify the risk factors of HEV infection by performing a systematic review and meta‐analysis.

A Nationwide Survey of Hepatitis E Virus Infection and Chronic Hepatitis in Heart and Kidney Transplant Recipients in Japan

The prevalence of anti-HEV IgG and HEV RNA in heart and kidney transplant recipients in Japan was lower than that in European countries, and of note, 42% of viremic transplant patients developed chronic hepatitis.

Mystery of Hepatitis E Virus: Recent Advances in Its Diagnosis and Management

This review paper discusses the recent advances in the knowledge of the hepatitis E virus itself, its epidemiology, diagnostic approach and prevention, and the treatment options available.

Hepatitis E Virus Seroprevalence Among Liver Transplant Recipients with Persistent Elevation of Liver Enzymes: A Single Center Report.

With 15.6% rate of HEV seropositivity in liver recipients with persistent elevation of liver enzymes, this study was not able to confirm any clinical evidence for active acute or chronic hepatitis E infection.

Transfusion-transmitted hepatitis E: What we know so far?

Immunosuppressed patients who develop persistent hepatitis E infection should have their immunosuppressant regimen reduced; ribavirin may be considered as treatment; Pegylated interferon can be considered in those who are refractory or intolerant to Ribavirin.



Chronic hepatitis E after solid organ transplantation.

A representative case report of an HEV-infected renal transplant recipient with chronic hepatitis E, successfully treated with ribavirin, is presented and studies are required to determine the optimal duration of ribvirin therapy and to assess outcome for solid organ transplant recipients with chronic HEV infection.

Infection with hepatitis E virus in kidney transplant recipients in southeastern France

Chronic HEV infection in kidney transplant recipients progress to chronicity in most cases and might be complicated by early liver cirrhosis, but ribavirin may be required if reduction of the immunosuppressant dose is not associated with HEV clearance or is inappropriate for the patient management.

Clinical implications of chronic hepatitis E virus infection in heart transplant recipients.

  • L. KoningS. Pas A. A. van der Eijk
  • Medicine, Biology
    The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
  • 2013

Hepatitis E Virus Infection without Reactivation in Solid-Organ Transplant Recipients, France

Effective prophylactic measures that include those for potential zoonotic infections should reduce the risk for HEV transmission in this population of solid-organ transplant recipients.

Factors associated with chronic hepatitis in patients with hepatitis E virus infection who have received solid organ transplants.

A retrospective analysis of data from 17 centers from Europe and the United States that described the progression, outcomes, and factors associated with development of chronic HEV infection in recipients of transplanted solid organs found tacrolimus therapy is the main predictive factor for chronic hepatitis.

Influence of Immunosuppressive Therapy on the Natural History of Genotype 3 Hepatitis-E Virus Infection After Organ Transplantation

The rate of chronic HEV-related hepatitis is approximately 60% in solid-organ transplant patients, and the reduction of immunosuppressive drugs targeting T cells should be considered as a first-line therapeutic option.

Hepatitis E virus: an underdiagnosed cause of chronic hepatitis in renal transplant recipients

A case of chronic HEV infection in a renal transplant recipient that went undiagnosed for many years is reported, and the therapeutic options are discussed.

Chronic hepatitis E infection in lung transplant recipients.

Treatment of chronic hepatitis E in a patient with HIV infection.

The clinical and laboratory response to antiviral therapy for chronic HEV infection in a patient also infected with HIV is described, with a 48-year-old bisexual male with HIV- 1 infection.

Hepatitis E infection is an under recognized cause of acute decompensation in patients with chronic liver disease.