Chronic hepatitis E in liver transplant recipients: a significant clinical problem?

Area of Science:

• Hepatology
• Virology
• Infectious Diseases

Background:

• Hepatitis E is an inflammatory liver disease caused by the Hepatitis E virus (HEV).
• HEV has five genotypes; genotypes 1 and 2 are human-specific, while genotypes 3 and 4 infect humans and animals.
• Hepatitis E is re-emerging as a zoonotic disease in industrialized nations, with increasing HEV genotype 3 infections.

Purpose of the Study:

• To review recent data on Hepatitis E.
• To highlight the significance of persistent HEV infections in liver transplant recipients.
• To emphasize the need for HEV RNA screening in specific patient groups.

Main Methods:

• Literature review of recent data on Hepatitis E.
• Focus on persistent HEV infections in immunocompromised patients.
• Analysis of HEV genotypes and their transmission patterns.

Main Results:

• Acute Hepatitis E is usually self-limiting but can be fulminant in pregnant women and those with chronic liver disease.
• Persistent HEV infections are reported in immunosuppressed patients, some developing progressive liver disease.
• HEV genotype 3 infections are rising in Western Europe and North America.

Conclusions:

• Screening for HEV RNA is crucial for elevated liver transaminases in organ transplant recipients and HIV-infected individuals.
• Persistent HEV infections pose a significant risk for progressive liver disease in immunocompromised patients.
• Hepatitis E is an emerging zoonotic concern, especially genotype 3, in developed countries.