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Hepatitis E in three immunocompromized children in southeastern France
Anne Motte1, Bertrand Roquelaure, Claire Galambrun
1Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Centre Hospitalo-Universitaire Timone, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France.
Summary
Hepatitis E virus (HEV) is an emerging cause of acute hepatitis in immunocompromized children in developed countries. Early HEV testing is crucial for this vulnerable pediatric population to prevent chronic infection and liver disease.
Area of Science:
- Hepatology
- Virology
- Pediatric Infectious Diseases
Background:
- Hepatitis E virus (HEV) is increasingly recognized as an autochthonous pathogen in developed nations, with established links to porcine reservoirs.
- While chronic HEV infection and cirrhosis are documented in immunocompromized adults, pediatric HEV infections remain understudied globally.
Observation:
- This report details three cases of acute hepatitis E in immunocompromized children in developed countries.
- The patients included a liver transplant recipient, a child with leukemia relapse, and a child with XIAP deficiency.
Findings:
- All three pediatric HEV infections were autochthonously acquired, involving different HEV genotype 3 subtypes common in Europe (f, c, and e).
- HEV RNA was persistently detected for 29 weeks in one case, highlighting the potential for prolonged infection.
Implications:
- These cases underscore the importance of considering HEV as a significant cause of hepatitis in immunocompromized children in developed countries.
- Routine HEV testing is recommended for immunocompromized children presenting with hepatitis to identify and manage potential chronic HEV infections.
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