Hepatitis E Virus (HEV) is an underrecognized cause of chronic hepatitis in the solid organ transplant (SOT) population. Amongst the liver transplant population, HEV viremia may persist and can cause advanced fibrosis and cirrhosis. A high index of suspicion is necessary for diagnosis. This is a case of a 63-year-old liver transplant recipient who presented with abnormal liver tests and ultimately diagnosed with chronic Hepatitis E. He was treated with Ribavirin with subsequent normalization of his liver tests.
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