Hepatitis E viral infection in solid organ transplant patients

Area of Science:

• Hepatology
• Infectious Diseases
• Transplantation Medicine

Background:

• Hepatitis E virus (HEV) infection is a rare but significant complication in solid organ transplant (SOT) recipients.
• Increasing recognition of chronic and persistent HEV infections in both developing and developed nations.
• HEV infection can lead to cirrhosis and fulminant hepatic failure in immunocompromised individuals.

Purpose of the Study:

• To review the literature from the past 10 years, with a focus on publications since 2015.
• To examine chronic HEV infection specifically in patients who have undergone solid organ transplantation.

Main Methods:

• Literature review of studies published within the last decade, emphasizing recent research from 2015 onwards.
• Focus on diagnostic methods, clinical manifestations, and management strategies for chronic HEV in SOT recipients.

Main Results:

• Diagnosis relies on HEV RNA detection in serum and stool, with stool analysis aiding in relapse prediction and therapy guidance.
• Current management emphasizes primary prevention and supportive care due to limited evidence for pharmacologic therapies.
• Ribavirin has demonstrated potential efficacy in case series for treating specific HEV genotypes.

Conclusions:

• Chronic HEV infection presents a growing challenge in SOT recipients, potentially leading to severe liver disease.
• Clinical presentation of HEV infection is often non-specific and can mimic other liver conditions.
• Further research is crucial to identify effective pharmacological treatments for chronic HEV in this vulnerable population.