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Hepatitis E in solid organ transplant recipients: A systematic review and meta-analysis
Panupong Hansrivijit1, Angkawipa Trongtorsak2, Max M Puthenpura3
1Department of Internal Medicine, UPMC Pinnacle, Harrisburg, PA 17104, United States.
World Journal of Gastroenterology
|April 8, 2021
Summary
Hepatitis E virus (HEV) infection is prevalent in solid organ transplant (SOT) recipients, affecting 20.2% of patients. Lung transplant recipients show a lower prevalence compared to other SOT groups.
Area of Science:
- Hepatology
- Infectious Diseases
- Transplant Medicine
Background:
- Hepatitis E virus (HEV) infection is often underdiagnosed due to low-sensitivity serological assays.
- While typically self-limiting, HEV can cause severe complications like liver decompensation and death in immunocompromised individuals, including solid organ transplant (SOT) recipients.
Purpose of the Study:
- To determine the overall prevalence of HEV infection in SOT recipients.
- To analyze HEV infection rates across different types of organ transplants.
Main Methods:
- A systematic literature search was conducted across major databases (Ovid MEDLINE, EMBASE, Cochrane Library) up to October 2020.
- Included studies focused on adult SOT recipients with confirmed HEV infection (via IgG, IgM, or RNA assays).
- A meta-analysis was performed on data from 22 eligible studies involving 4557 patients.
Main Results:
- The pooled prevalence of HEV infection in SOT recipients was 20.2%.
- Prevalence varied by organ: liver (27.2%), kidney (12.8%), heart (12.8%), and lung (5.6%).
- HEV infection was significantly more common in middle-income countries and de novo/acute infections were estimated at 5.1% and 4.3% respectively.
Conclusions:
- HEV infection is a common concern in SOT recipients, with higher rates observed in middle-income countries.
- Lung transplant recipients have a lower prevalence of HEV infection compared to other SOT recipients.
- Further research is needed to understand the clinical impact of HEV on SOT outcomes, including graft failure, rejection, and mortality.
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