When HEV infection meets organ transplantation

Hepatitis E virus (HEV), a single-stranded RNA virus, is a leading cause of acute viral hepatitis globally. In recent years, the incidence of hepatitis E has increased significantly, making it a major public health concern globally. Solid organ transplant (SOT) recipients, who require long-term immunosuppressive therapy to prevent graft rejection, are particularly vulnerable to HEV infection because of their immunocompromised state. This population faces a heightened risk of developing chronic hepatitis E, which can progress to liver fibrosis and cirrhosis. Therefore, it is crucial to prioritize the monitoring of SOT recipients in clinical practice, to elucidate the associated risk factors further, and implement stringent diagnostic and preventive measures. Building on previous research, this paper comprehensively reviews the virological characteristics of HEV and the epidemiological features, clinical manifestations, diagnostic approaches, and therapeutic strategies for HEV infection in SOT recipients. The aim of this study is to provide valuable insights for effectively managing, treating, and preventing HEV infection in this high-risk population.