Hepatitis E infection in stem cell and solid organ transplantpatients: A cross-sectional study

Hepatitis E virus is an infrequent but potentially serious infection in allogeneic hematopoietic stem cell transplant recipients

“…This has mostly been described in SOT recipients 153 , but also in patients with HIV 154 , rheumatological disorders 155 and hematological malignancy 156 . The reported frequency of patients tested positive for HEV RNA after HSCT has been 0% in two small cohorts 157,158 , and 0.4-2.4% in larger cohorts with 111-328 patients 39,159,160 . Moreover,…”

Hepatitis E virus in hematopoietic stem cell transplant recipients: A systematic review

“…The fact that there is no standardized case definition, in addition to the heterogeneity in the analytical sensitivity of the commercial HEV assays, makes the comparison of studies more difficult. In this systematic review, all the seven studies performed the detection of HEV RNA, the most robust marker of acute/active infection [18,21,[35][36][37][38][39], while four performed also the detection of anti-HEV IgM/IgG [18,35,37,38]. The studies that performed HEV RNA detection as the diagnostic method for HEV infection in HSCT recipients revealed similar results between them, with an overall prevalence of HEV infection of 1.5%.…”

“…After the full revision process, we included 7 manuscripts for data analysis [18,21,[35][36][37][38][39] (Table 1). Overall, these 7 studies included a total of 1178 HSCT patients from different countries: six studies were performed in Europe (United Kingdom, Netherlands, France, and Germany) [18,21,36,36,37,38,39] and one study in China 35]. These studies evaluated the prevalence of HEV infection based on the detection of HEV RNA (n = 7) and/or the presence of anti-HEV IgM (n = 3)/IgG (n = 4).…”

“…These studies evaluated the prevalence of HEV infection based on the detection of HEV RNA (n = 7) and/or the presence of anti-HEV IgM (n = 3)/IgG (n = 4). Phylogenetic analysis was performed in only three of these seven studies, revealing only HEV-3 genotype [21,37,39].…”

“…In China, a study evaluated HEV infection in 177 haploidentical-HSCT recipients that presented unexplained elevated transaminases after transplant, identifying 7 patients with an acute/current HEV infection (2 positives for HEV RNA and 5 positives for anti-HEV IgM/IgG) [35]. In the United Kingdom, two studies identified a total of 4 recipients with an acute HEV infection based in the presence of HEV RNA: in one study, 259 HSCT recipients (111 allo-HSCT, 145 auto-HSCT, and 3 CD34 top-up procedures) were evaluated and only 1 HEV RNA positive patient was identified [39]; while the other study analyzed 144 allo-HSCT recipients and 3 patients were positive for HEV RNA [21]. In the Netherlands, two studies analysed HEV infection in HSCT: one study was performed in 130 allo-HSCT recipients with elevated alanine aminotransferase (ALT), identifying 5 HEV RNA positive patients [36]; the other study analyzed 328 allo-HSCT recipients transplanted over a 5year period, identifying a total of 10 patients with a current infection (8 were positive for HEV RNA and 2 were positive for anti-HEV IgM) and 41 patients were seropositive for anti-HEV IgG [37].…”