Prevalence of hepatitis E virus infection in pediatric solid organ transplant recipients – A single‐center experience

Abstract

HEV infection appears to be an emerging disease in industrialized countries. The aim of this study was to evaluate the prevalence of HEV infection in pediatric solid organ transplant recipients. One hundred and twenty-four pediatric recipients of liver (n = 41) or kidney (n = 83) transplants aged between one and 18 yr were screened for anti-HEV IgG antibodies. Patients were tested for fecal HEV RNA excretion if they showed anti-HEV seropositivity. As a control group, 108 immunocompetent pediatric patients without liver disease aged between three and 18 yr were screened for anti-HEV IgG. HEV seroprevalence was 2.4% in renal Tx (2/83), 4.9% in liver Tx patients (2/41), and 3.2% overall (4/124). Three of these four patients were HEV RNA-negative. In one renal transplant patient, HEV genotype 3 RNA excretion persisted and liver enzymes were elevated, indicating chronic hepatitis. In the control group, eight patients (7.4%) were HEV IgG-positive without biochemical evidence of hepatitis. The prevalence of HEV infection in pediatric renal or liver transplant recipients is not higher compared with immunocompetent children. Chronic HEV infection with long-term carriage of the virus may develop in pediatric transplant recipients. Autochthonous HEV infection needs to be considered in uncertain cases of hepatitis in immunosuppressed as well as immunocompetent children.

Chronic Hepatitis E Virus Infection in a Pediatric Female Liver Transplant Recipient

“…Infections caused by HEV can become chronic, with persistently elevated aminotransferase levels and persistent viremia in immunocompromised adults and children; certain chronic cases have been described in pediatric patients with HIV or hematological malignancies and in pediatric patients who have received solid-organ transplants (1)(2)(3)(4).…”

Chronic Hepatitis E Virus Infection and Treatment

“…9,[11][12][13][14]16,17 Seroprevalence and Incidence of HEV Infection Among Pediatric Patients with a SOT A few cases of acute and chronic HEV have been reported in liver-and kidney-transplant patients from Quebec, France, and Germany. [18][19][20][21] In these patients, HEV seroprevalence, assessed by different serological assays, ranged from 2.3 to 86%. 18,20 HEV-related cirrhosis in a child who had undergone a bone-marrow transplant was reported.…”

“…[18][19][20][21] In these patients, HEV seroprevalence, assessed by different serological assays, ranged from 2.3 to 86%. 18,20 HEV-related cirrhosis in a child who had undergone a bone-marrow transplant was reported. 25 A single case of HEV reactivation has been also reported in a patient with acute lymphoblastic leukemia after an allogeneic stem-cell transplant.…”

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

“…6,17 In children, few studies have been published. 12,13,[18][19][20] Only 1 study concerned children after kidney transplantation. 18 The transmission of endemic HEV is thought to occur through contaminated or undercooked food or blood transfusions, blood products, and organ transplants.…”

“…12,13,[18][19][20] Only 1 study concerned children after kidney transplantation. 18 The transmission of endemic HEV is thought to occur through contaminated or undercooked food or blood transfusions, blood products, and organ transplants. Patient A in this report acquired hepatitis E several years after transplantation and thus his infection was probably foodborne, not from the organ donor or from blood products.…”