Donor-Derived Genotype 4 Hepatitis E Virus Infection, Hong Kong, China, 2018.

Emerging Infectious Diseases
Siddharth SridharKwok-Yung Yuen

Abstract

Hepatitis E virus (HEV) genotype 4 (HEV-4) is an emerging cause of acute hepatitis in China. Less is known about the clinical characteristics and natural history of HEV-4 than HEV genotype 3 infections in immunocompromised patients. We report transmission of HEV-4 from a deceased organ donor to 5 transplant recipients. The donor had been viremic but HEV IgM and IgG seronegative, and liver function test results were within reference ranges. After a mean of 52 days after transplantation, hepatitis developed in all 5 recipients; in the liver graft recipient, disease was severe and with progressive portal hypertension. Despite reduced immunosuppression, all HEV-4 infections progressed to persistent hepatitis. Four patients received ribavirin and showed evidence of response after 2 months. This study highlights the role of organ donation in HEV transmission, provides additional data on the natural history of HEV-4 infection, and points out differences between genotype 3 and 4 infections in immunocompromised patients.

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Citations

May 15, 2019·Expert Review of Anti-infective Therapy·Sébastien LhommeJacques Izopet
May 22, 2019·Viruses·Putu Prathiwi PrimadharsiniHiroaki Okamoto
Jan 22, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Siddharth SridharKwok-Yung Yuen
Dec 11, 2020·Journal of Viral Hepatitis·Myrte GorrisJoep de Bruijne
Dec 10, 2020·Journal of Immunology Research·Jian WuLanjuan Li
Feb 13, 2021·Viruses·Shaoli Lin, Yan-Jin Zhang
Nov 1, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Siddharth SridharKwok-Yung Yuen

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Methods Mentioned

BETA
reverse transcription PCR
ELISA
ELISAs
biopsy
nucleic acid amplification

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