Hepatitis e infection in a renal transplant recipient

Area of Science:

• Hepatology
• Transplant Immunology
• Virology

Background:

• Hepatitis E virus (HEV) infection is an emerging concern in UK transplant populations.
• HEV infection can progress to liver cirrhosis, posing significant risks to immunocompromised individuals.
• The incidence, natural history, and optimal treatment of HEV in transplant recipients remain poorly understood.

Purpose of the Study:

• To report a case of Hepatitis E virus genotype 3 infection in an asymptomatic renal transplant recipient.
• To illustrate the pattern of delayed spontaneous clearance of HEV infection in this patient group.
• To contribute to the understanding of HEV natural history in immunocompromised hosts.

Main Methods:

• Liver function tests and liver biopsy were performed.
• Extensive viral screening was conducted to identify the causative agent.
• Clinical course and viral clearance were monitored over time.

Main Results:

• The patient, a 35-year-old renal transplant recipient, presented with abnormal liver function tests.
• Liver biopsy indicated a viral-mediated portal inflammatory process with fibrosis.
• Hepatitis E virus genotype 3 (HEV-3) infection was confirmed, with delayed spontaneous viral clearance observed.

Conclusions:

• This case demonstrates that HEV-3 infection can occur in renal transplant recipients and may exhibit delayed spontaneous clearance.
• Awareness and monitoring of HEV infection are crucial in transplant populations due to potential severe outcomes like cirrhosis.
• Further research is needed to establish the incidence, natural history, and management strategies for HEV in transplant recipients.