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Panminerva Medica 2020 Jul 22

DOI: 10.23736/S0031-0808.20.03877-X

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Seroprevalence of Hepatitis E Virus in liver transplant patients in Turin, Italy

Elisa ZANOTTO 1, Massimo RITTÁ 1, Fabrizia PITTALUGA 1, Silvia MARTINI 2, Marco CIOTTI 3, Rossana CAVALLO 1, Cristina COSTA 1

1 Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy; 2 Gastrohepatology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy; 3 Department of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy


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BACKGROUND: Acute E hepatitis is usually a self-limited non-progressive disease; however, acute liver failure and death can occur in the presence of particular conditions such as pregnancy and chronic liver diseases. In immunocompromised individuals, such as transplant patients, acute hepatitis E virus (HEV) infection may evolve to chronic hepatitis with rapid progression to liver decompensation. At our center, serology for HEV is not routinely performed in transplant patients and serological status is investigated only on the basis of clinical judgement.
METHODS: In this study, seroprevalence of HEV was evaluated in 217 patients (120 liver transplant recipients and 97 individuals diagnosed with acute or chronic hepatitis). Molecular evaluation of HEV-RNA was also performed.
RESULTS: Thirteen patients (6%) showed positivity for HEV-IgG; in particular, 10/120 (8.3%), with concomitant presence of IgM and IgG in six and 3/97 (3.1%). None of the plasma samples tested by HEV-RNA was positive.
CONCLUSIONS: As the detectable RNA window is narrow and an undetectable HEVRNA result does not exclude recent infection and the transplant context per se represents a risk factor for chronic infection in patients infected with HEV, a routine diagnostic workflow including HEV should be taken into consideration, increasing awareness and knowledge of the basic and clinical aspects of the disease.


KEY WORDS: Hepatitis E virus; Serology; HEV-RNA

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