Hoerning André, Hegen Bianca, Wingen Anne-Margret, Cetiner Metin, Lainka Elke, Kathemann Simone, Fiedler Melanie, Timm Jörg, Wenzel Jürgen J, Hoyer Peter F, Gerner Patrick
Pediatrics II, Department for Pediatric Nephrology, Gastroenterology, Endocrinology and Transplant Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Pediatr Transplant. 2012 Nov;16(7):742-7. doi: 10.1111/j.1399-3046.2012.01740.x. Epub 2012 Jun 28.
HEV infection appears to be an emerging disease in industrialized countries. The aim of this study was to evaluate the prevalence of HEV infection in pediatric solid organ transplant recipients. One hundred and twenty-four pediatric recipients of liver (n = 41) or kidney (n = 83) transplants aged between one and 18 yr were screened for anti-HEV IgG antibodies. Patients were tested for fecal HEV RNA excretion if they showed anti-HEV seropositivity. As a control group, 108 immunocompetent pediatric patients without liver disease aged between three and 18 yr were screened for anti-HEV IgG. HEV seroprevalence was 2.4% in renal Tx (2/83), 4.9% in liver Tx patients (2/41), and 3.2% overall (4/124). Three of these four patients were HEV RNA-negative. In one renal transplant patient, HEV genotype 3 RNA excretion persisted and liver enzymes were elevated, indicating chronic hepatitis. In the control group, eight patients (7.4%) were HEV IgG-positive without biochemical evidence of hepatitis. The prevalence of HEV infection in pediatric renal or liver transplant recipients is not higher compared with immunocompetent children. Chronic HEV infection with long-term carriage of the virus may develop in pediatric transplant recipients. Autochthonous HEV infection needs to be considered in uncertain cases of hepatitis in immunosuppressed as well as immunocompetent children.
戊型肝炎病毒（HEV）感染在工业化国家似乎是一种新出现的疾病。本研究的目的是评估小儿实体器官移植受者中HEV感染的患病率。对124例年龄在1至18岁之间的肝移植（n = 41）或肾移植（n = 83）小儿受者进行了抗HEV IgG抗体筛查。如果患者抗HEV血清学呈阳性，则检测其粪便中的HEV RNA排泄情况。作为对照组，对108例年龄在3至18岁之间无肝病的免疫功能正常的小儿患者进行了抗HEV IgG筛查。肾移植受者中HEV血清阳性率为2.4%（2/83），肝移植患者中为4.9%（2/41），总体为3.2%（4/124）。这4例患者中有3例HEV RNA阴性。在1例肾移植患者中，HEV 3型RNA持续排泄且肝酶升高，提示为慢性肝炎。在对照组中，8例患者（7.4%）抗HEV IgG阳性，但无肝炎的生化证据。小儿肾或肝移植受者中HEV感染的患病率与免疫功能正常的儿童相比并不更高。小儿移植受者可能会发生病毒长期携带的慢性HEV感染。在免疫抑制及免疫功能正常儿童的不明原因肝炎病例中，需要考虑本土HEV感染。
