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Hepatitis E virus and the kidney in solid-organ transplant patients
Nassim Kamar1, Hugo Weclawiak, Céline Guilbeau-Frugier
1Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, Toulouse, France. kamar.n@chu-toulouse.fr
Transplantation
|February 3, 2012
Summary
Hepatitis E virus (HEV) infection can cause kidney problems, including glomerulonephritis, in transplant patients. Kidney function improves after the virus is cleared, suggesting HEV is a cause of these extrahepatic manifestations.
Area of Science:
- Nephrology
- Hepatology
- Virology
Background:
- Hepatitis E virus (HEV) infection is increasingly recognized in industrialized nations.
- Limited data exist on extrahepatic manifestations of genotype 3 HEV infections.
Observation:
- This study evaluated kidney function and histology in 51 solid-organ transplant patients with genotype 3 HEV infection.
- Kidney function, assessed by estimated glomerular filtration rate (eGFR) and proteinuria, was monitored during infection and follow-up.
- Kidney biopsies were performed on patients with significant proteinuria and reduced eGFR.
Findings:
- HEV infection led to a significant decrease in eGFR in kidney and liver transplant recipients.
- Kidney biopsies revealed glomerular diseases, including membranoproliferative glomerulonephritis and IgA nephropathy relapses.
- Cryoglobulinemia was common but resolved after HEV clearance, with improved kidney function and reduced proteinuria.
Implications:
- HEV-associated glomerulonephritis represents a potential extrahepatic manifestation of HEV infection.
- These findings highlight the importance of considering HEV in transplant patients presenting with renal abnormalities.
- Further research is needed to confirm the causal link between HEV and glomerulonephritis.
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