Hepatitis E Virus Infection in Iranian Kidney-Transplant Patients

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Article Information:


Group: 2011
Subgroup: Volume 11, Issue 11, Nov
Date: November 2011
Type: Letter to Editor
Start Page: 927
End Page: 928
PMID: 22308159
PMCID: 3269063
DOI: 10.5812/kowsar.1735143X.791

Authors:

  • Nassim Kamar
  • Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, Toulouse, France

      Correspondence:

      Affiliation: Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil
      City, Province: Toulouse,
      Country: France
      Tel: +33-561322335
      Fax: +33-561323989
      E-mail: kamar.n@ chu-toulouse.fr

Manuscript Body:


  • Please cite this paper as:
    Kamar N. Hepatitis E Virus Infection in Iranian Kidney-Transplant Patients. Hepat Mon. 2011;11(11):927-8.
  • Article type:
    Letter to Editor
  • Article history:
    Received: 23 Oct 2011
    Revised: 06 Nov 2011
    Accepted: 12 Nov 2011
  • Keywords:
    Hepatitis E;idney Transplantation;atients;Dear Editor
  • DOI: 10.5812/kowsar.1735143X.791

© 2011, BRCGL, Published by Kowsar M.P.Co. All rights reserved.


Dear Editor, 

Hepatitis E virus infection is an endemic disease in developing and industrialized countries (1),and is responsible for acute and chronic hepatitis. Genotype 1 is more prevalent in developing countries, whereas genotype 3 is more common in developed countries (1). Chronic genotype 3 HEV infection can occur in solid-organ transplant patients (2), hematological patients who receive chemotherapy (3), and HIV-positive patients (4). In the past several years, HEV infection in organ transplant patients has garnered much interest. After kidney transplantation, HEV-related liver fibrosis can lead rapidly to cirrhosis (5). The use of tacrolimus, rather than cyclosporine A, and a low platelet count at HEV diagnosis have been identified as predictive factors for chronic HEV infection (6). However, decreased immunosuppressant dose can result in HEV clearance in nearly one-third of patients (6). In addition, ribavirin monotherapy can be efficacious in treating chronic HEV infection (7).
In this issue of Hepatitis Monthly, Khameneh et al. determined the prevalence of anti-HEV IgG in 91 randomly selected Iranian kidney transplant patients (8). The HEV seroprevalence was 30.8%, although there was poor sensitivity and specificity between HEV serological assays (9). However, this study on seroprevalence in an Iranian kidney transplant population is a first step toward improving the assessment of HEV infection in this setting. Unfortunately, as discussed by the authors, HEV RNA was not measured in this study. Consequently, the authors were unable to determine whether some patients developed chronic hepatitis-a significant shortcoming, because 45.1% of patients had unexplained increases in liver function tests (8). The measurement of HEV genotype may also be valuable, because, similar to what has been observed in Europe, Khameneh et al. found more positive HEV serologies in older patients (8).
In summary, Khamaneh et al. noted a high seroprevalence rate of HEV in an Iranian kidney transplant population. Further studies are needed to evaluate the impact of HEV infection in this population.

  • Financial Disclosure
    None declared.

References: (9)

  1. Dalton HR, Bendall R, Ijaz S, Banks M. Hepatitis E: an emerging infection in developed countries. The Lancet infectious diseases. 2008;8(11):698-709. [PubMed][DOI: 10.1016/S1473-3099(08)70255-X ]
  2. Kamar N, Selves J, Mansuy JM, Ouezzani L, Peron JM, Guitard J, et al. Hepatitis E virus and chronic hepatitis in organ-transplant recipients. The New England journal of medicine. 2008;358(8):811-7. [PubMed][DOI: 10.1056/NEJMoa0706992 ]
  3. Ollier L, Tieulie N, Sanderson F, Heudier P, Giordanengo V, Fuzibet J, et al. Chronic Hepatitis After Hepatitis E Virus Infection in a Patient With Non-Hodgkin Lymphoma Taking Rituximab. Ann Intern Med. 2009;150(6):430-1. [PubMed]
  4. Dalton HR, Bendall RP, Keane FE, Tedder RS, Ijaz S. Persistent carriage of hepatitis E virus in patients with HIV infection. The New England journal of medicine. 2009;361(10):1025-27. [PubMed][DOI: 10.1056/NEJMc0903778 ]
  5. Kamar N, Abravanel F, Selves J, Garrouste C, Esposito L, Lavayssiere L, et al. Influence of immunosuppressive therapy on the natural history of genotype 3 hepatitis-E virus infection after organ transplantation. Transplantation. 2010;89(3):353-60. [PubMed][DOI: 10.1097/TP.0b013e3181c4096c ]
  6. Kamar N, Garrouste C, Haagsma EB, Garrigue V, Pischke S, Chauvet C, et al. Factors associated with chronic hepatitis in patients with hepatitis E virus infection who have received solid organ transplants. Gastroenterology. 2011;140(5):1481-9. [PubMed][DOI: 10.1053/j.gastro.2011.02.050 ]
  7. Kamar N, Rostaing L, Abravanel F, Garrouste C, Lhomme S, Esposito L, et al. Ribavirin therapy inhibits viral replication on patients with chronic hepatitis E virus infection. Gastroenterology. 2010;139(5):1612-8. [PubMed][DOI: 10.1053/j.gastro.2010.08.002 ]
  8. Khameneh ZR, Sepehrvand N, Masudi S. Seroprevalence of Hepatitis E among Iranian renal transplant recipients. Hepat Mon. 2011;11(8):646-51. [Hepat Mon][DOI: 10.5812/kowsar.1735143X.690 ]
  9. Bendall R, Ellis V, Ijaz S, Ali R, Dalton H. A comparison of two commercially available anti-HEV IgG kits and a re-evaluation of anti-HEV IgG seroprevalence data in developed countries. J Med Virol. 2010;82(5):799-805. [PubMed][DOI: 10.1002/jmv.21656]