Hepatitis E virus is an infrequent but potentially serious infection in allogeneic hematopoietic stem cell transplant recipients.
Journal
Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
09
12
2019
accepted:
30
01
2020
revised:
27
01
2020
pubmed:
20
2
2020
medline:
22
6
2021
entrez:
20
2
2020
Statut:
ppublish
Résumé
Hepatitis E virus (HEV) can cause chronic infection and liver cirrhosis in immunocompromised individuals. The frequency and clinical importance of HEV was studied retrospectively in a cohort of 236 Swedish allogeneic hematopoietic stem cell transplantation (HSCT) recipients. In blood samples collected at 6 months after HSCT, HEV RNA was identified in 8/236 (3.4%) patients, and 11/236 (4.7%) patients had detectable anti-HEV IgG and/or IgM, eight of whom were HEV RNA negative. Two of the patients with positive HEV RNA died with ongoing signs of hepatitis: one of acute liver and multiple organ failure, the other of unrelated causes. The remaining six patients with HEV RNA had cleared the infection at 7-24 (median 8.5) months after HSCT. HEV infection was associated with elevated alanine aminotransferase at 6 months after HSCT (OR 15, 1.3-174, p = 0.03). Active graft-versus-host disease of the liver at 6 months after HSCT was present in 3/8 (38%) patients with HEV RNA, but was not significantly associated with HEV infection. In conclusion, HEV infection is an important differential diagnosis in patients with elevated liver enzymes after HSCT. Although spontaneous clearance was common, the clinical course may be severe.
Identifiants
pubmed: 32071417
doi: 10.1038/s41409-020-0823-7
pii: 10.1038/s41409-020-0823-7
doi:
Substances chimiques
RNA, Viral
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1255-1263Références
Kamar N, Izopet J, Pavio N, Aggarwal R, Labrique A, Wedemeyer H, et al. Hepatitis E virus infection. Nat Rev Dis Prim. 2017;3:17086. https://doi.org/10.1038/nrdp.2017.86 .
doi: 10.1038/nrdp.2017.86
pubmed: 29154369
Hewitt PE, Ijaz S, Brailsford SR, Brett R, Dicks S, Haywood B, et al. Hepatitis E virus in blood components: a prevalence and transmission study in southeast England. Lancet. 2014;384:1766–73. https://doi.org/10.1016/s0140-6736(14)61034-5 .
doi: 10.1016/s0140-6736(14)61034-5
pubmed: 25078306
Koenecke C, Pischke S, Beutel G, Ritter U, Ganser A, Wedemeyer H, et al. Hepatitis E virus infection in a hematopoietic stem cell donor. Bone Marrow Transplant. 2014;49:159–60. https://doi.org/10.1038/bmt.2013.148 .
doi: 10.1038/bmt.2013.148
pubmed: 24056741
Schlosser B, Stein A, Neuhaus R, Pahl S, Ramez B, Kruger DH, et al. Liver transplant from a donor with occult HEV infection induced chronic hepatitis and cirrhosis in the recipient. J Hepatol. 2012;56:500–2. https://doi.org/10.1016/j.jhep.2011.06.021 .
doi: 10.1016/j.jhep.2011.06.021
pubmed: 21798217
Guillois Y, Abravanel F, Miura T, Pavio N, Vaillant V, Lhomme S, et al. High proportion of asymptomatic infections in an outbreak of hepatitis E associated with a spit-roasted piglet, France, 2013. Clin Infect Dis. 2016;62:351–7. https://doi.org/10.1093/cid/civ862 .
doi: 10.1093/cid/civ862
pubmed: 26429341
Kamar N, Selves J, Mansuy JM, Ouezzani L, Peron JM, Guitard J, et al. Hepatitis E virus and chronic hepatitis in organ-transplant recipients. N Engl J Med. 2008;358:811–7. https://doi.org/10.1056/NEJMoa0706992 .
doi: 10.1056/NEJMoa0706992
pubmed: 18287603
Dalton HR, Bendall RP, Keane FE, Tedder RS, Ijaz S. Persistent carriage of hepatitis E virus in patients with HIV infection. N Engl J Med. 2009;361:1025–7. https://doi.org/10.1056/NEJMc0903778 .
doi: 10.1056/NEJMc0903778
pubmed: 19726781
Ollier L, Tieulie N, Sanderson F, Heudier P, Giordanengo V, Fuzibet JG, et al. Chronic hepatitis after hepatitis E virus infection in a patient with non-Hodgkin lymphoma taking rituximab. Ann Intern Med. 2009;150:430–1.
doi: 10.7326/0003-4819-150-6-200903170-00026
Versluis J, Pas SD, Agteresch HJ, de Man RA, Maaskant J, Schipper ME, et al. Hepatitis E virus: an underestimated opportunistic pathogen in recipients of allogeneic hematopoietic stem cell transplantation. Blood. 2013;122:1079–86. https://doi.org/10.1182/blood-2013-03-492363 .
doi: 10.1182/blood-2013-03-492363
pubmed: 23794068
Koenecke C, Pischke S, Heim A, Raggub L, Bremer B, Raupach R, et al. Chronic hepatitis E in hematopoietic stem cell transplant patients in a low-endemic country? Transpl Infect Dis. 2012;14:103–6. https://doi.org/10.1111/j.1399-3062.2011.00702.x .
doi: 10.1111/j.1399-3062.2011.00702.x
pubmed: 22212560
Remberger M, Ackefors M, Berglund S, Blennow O, Dahllof G, Dlugosz A, et al. Improved survival after allogeneic hematopoietic stem cell transplantation in recent years. A single-center study. Biol Blood Marrow Transpl. 2011;17:1688–97. https://doi.org/10.1016/j.bbmt.2011.05.001 .
doi: 10.1016/j.bbmt.2011.05.001
Torlen J, Ringden O, Garming-Legert K, Ljungman P, Winiarski J, Remes K, et al. A prospective randomized trial comparing cyclosporine/methotrexate and tacrolimus/sirolimus as graft-versus-host disease prophylaxis after allogeneic hematopoietic stem cell transplantation. Haematologica. 2016;101:1417–25. https://doi.org/10.3324/haematol.2016.149294 .
doi: 10.3324/haematol.2016.149294
pubmed: 27662016
pmcid: 5394879
Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J, et al. 1994 consensus conference on acute GVHD grading. Bone Marrow Transplant. 1995;15:825–8.
pubmed: 7581076
Filipovich AH, Weisdorf D, Pavletic S, Socie G, Wingard JR, Lee SJ, et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant. 2005;11:945–56. https://doi.org/10.1016/j.bbmt.2005.09.004 .
doi: 10.1016/j.bbmt.2005.09.004
pubmed: 16338616
Norder H, Karlsson M, Mellgren A, Konar J, Sandberg E, Lasson A, et al. Diagnostic performance of five assays for anti-hepatitis E virus IgG and IgM in a large cohort study. J Clin Microbiol. 2016;54:549–55. https://doi.org/10.1128/jcm.02343-15 .
doi: 10.1128/jcm.02343-15
pubmed: 26659210
pmcid: 4767966
Roth A, Lin J, Magnius L, Karlsson M, Belak S, Widen F, et al. Markers for ongoing or previous hepatitis E virus infection are as common in wild ungulates as in humans in Sweden. Viruses. 2016;8. https://doi.org/10.3390/v8090259 .
Pagano M, Gauvreau K. Principles of Biostatistics, 2nd edition. Pacific Grove, CA: Duxbury; 2000.
Sheskin DJ. Handbook of parametric and nonparametric statistical procedures, 4th edition. Boca Raton, FL: Chapman & Hall/ CRC; 2004.
Willemse SB, Bezuur DL, Blom P, Kneppers E, Verheij J, Zaaijer HL, et al. Hepatitis E virus infection and hepatic GvHD in allogeneic hematopoietic stem cell transplantation recipients. Bone Marrow Transplant. 2017;52:622–4. https://doi.org/10.1038/bmt.2016.327 .
doi: 10.1038/bmt.2016.327
pubmed: 27991886
Tang FF, Mo XD, Wang Y, Yan CH, Chen YH, Chen H, et al. Hepatitis E virus infection after haploidentical haematopoietic stem cell transplantation: incidence and clinical course. Br J Haematol. 2019;184:788–96. https://doi.org/10.1111/bjh.15672 .
doi: 10.1111/bjh.15672
pubmed: 30426480
Abravanel F, Mansuy JM, Huynh A, Kamar N, Alric L, Peron JM, et al. Low risk of hepatitis E virus reactivation after haematopoietic stem cell transplantation. J Clin Virol. 2012;54:152–5. https://doi.org/10.1016/j.jcv.2012.02.015 .
doi: 10.1016/j.jcv.2012.02.015
pubmed: 22425538
Reekie I, Irish D, Ijaz S, Fox T, Bharucha T, Griffiths P, et al. Hepatitis E infection in stem cell and solid organ transplantpatients: a cross-sectional study: the importance of HEV RNA screening in peri-transplant period. J Clin Virol. 2018;107:1–5. https://doi.org/10.1016/j.jcv.2018.07.011 .
doi: 10.1016/j.jcv.2018.07.011
pubmed: 30099145
Carre M, Thiebaut-Bertrand A, Larrat S, Leroy V, Pouzol P, Sturm N, et al. Fatal autochthonous fulminant hepatitis E early after allogeneic stem cell transplantation. Bone Marrow Transplant. 2017;52:643–5. https://doi.org/10.1038/bmt.2016.337 .
doi: 10.1038/bmt.2016.337
pubmed: 28067868
von Felden J, Alric L, Pischke S, Aitken C, Schlabe S, Spengler U, et al. The burden of hepatitis E among patients with haematological malignancies: a retrospective European cohort study. J Hepatol. 2019;71:465–72. https://doi.org/10.1016/j.jhep.2019.04.022 .
doi: 10.1016/j.jhep.2019.04.022
Tuncer HH, Rana N, Milani C, Darko A, Al-Homsi SA. Gastrointestinal and hepatic complications of hematopoietic stem cell transplantation. World J Gastroenterol. 2012;18:1851–60. https://doi.org/10.3748/wjg.v18.i16.1851 .
doi: 10.3748/wjg.v18.i16.1851
pubmed: 22563164
pmcid: 3337559
Donnelly MC, Scobie L, Crossan CL, Dalton H, Hayes PC, Simpson KJ. Review article: hepatitis E—a concise review of virology, epidemiology, clinical presentation and therapy. Aliment Pharmacol Ther. 2017;46:126–41. https://doi.org/10.1111/apt.14109 .
doi: 10.1111/apt.14109
pubmed: 28449246
Wahren B, Gahrton G, Linde A, Ljungman P, Lonnqvist B, Ringden O, et al. Transfer and persistence of viral antibody-producing cells in bone marrow transplantation. J Infect Dis. 1984;150:358–65. https://doi.org/10.1093/infdis/150.3.358 .
doi: 10.1093/infdis/150.3.358
pubmed: 6090542
Baylis SA, Gartner T, Nick S, Ovemyr J, Blumel J. Occurrence of hepatitis E virus RNA in plasma donations from Sweden, Germany and the United States. Vox Sang. 2012;103:89–90. https://doi.org/10.1111/j.1423-0410.2011.01583.x .
doi: 10.1111/j.1423-0410.2011.01583.x
pubmed: 22220775
Thom K, Gilhooly P, McGowan K, Malloy K, Jarvis LM, Crossan C, et al. Hepatitis E virus (HEV) in Scotland: evidence of recent increase in viral circulation in humans. Euro Surveill: Bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin. 2018;23. https://doi.org/10.2807/1560-7917.Es.2018.23.12.17-00174 .
Boland F, Martinez A, Pomeroy L, O’Flaherty N. Blood donor screening for hepatitis E virus in the European Union. Transfus Med Hemother. 2019;46:95–103. https://doi.org/10.1159/000499121 .
doi: 10.1159/000499121
pubmed: 31191195
pmcid: 6514502
Norder H, Galli C, Magnil E, Sikora P, Ekvarn E, Nystrom K, et al. Hepatitis E virus genotype 3 genomes from RNA-positive but serologically negative plasma donors have CUG as the Start Codon for ORF3. Intervirology. 2018;61:96–103. https://doi.org/10.1159/000491926 .
doi: 10.1159/000491926
pubmed: 30278453
pmcid: 6262685
Norder H, Sundqvist L, Magnusson L, Ostergaard Breum S, Lofdahl M, Larsen LE, et al. Endemic hepatitis E in two Nordic countries. Euro Surveill: bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin. 2009;14:pii: 19211.
Boxman ILA, Jansen CCC, Hagele G, Zwartkruis-Nahuis A, Tijsma ASL, Vennema H. Monitoring of pork liver and meat products on the Dutch market for the presence of HEV RNA. Int J Food Microbiol. 2019;296:58–64. https://doi.org/10.1016/j.ijfoodmicro.2019.02.018 .
doi: 10.1016/j.ijfoodmicro.2019.02.018
pubmed: 30849707
Wang H, Castillo-Contreras R, Saguti F, Lopez-Olvera JR, Karlsson M, Mentaberre G, et al. Genetically similar hepatitis E virus strains infect both humans and wild boars in the Barcelona area, Spain, and Sweden. Transbound Emerg Dis. 2019;66:978–85. https://doi.org/10.1111/tbed.13115 .
doi: 10.1111/tbed.13115
pubmed: 30597741
Agency EM. Reflection paper on viral safety of plasma-derived medicinal products with respect to hepatitis E virus. London: European Medicines Agency; 2016.
EASL. Clinical Practice Guidelines on hepatitis E virus infection. J Hepatol. 2018;68:1256–71. https://doi.org/10.1016/j.jhep.2018.03.005 .
doi: 10.1016/j.jhep.2018.03.005