Zeraati Abbas Ali, Nazemian Fatemeh, Takalloo Ladan, Sahebkar Amirhossein, Heidari Elahe, Yaghoubi Mohammad Ali
Kidney transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
EXCLI J. 2016 Jun 2;15:343-9. doi: 10.17179/excli2016-232. eCollection 2016.
Although hepatitis E virus (HEV) is well known to cause acute hepatitis, there are reports showing that HEV may also be responsible for progression of acute to chronic hepatitis and liver cirrhosis in patients receiving organ transplantation. In this study, we aimed to evaluate the prevalence of HEV in patients with kidney transplantation. In this study, 110 patients with kidney transplantation were recruited, and anti-HEV IgG, creatinine, alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and estimated glomerular filtration rate (eGFR) in the first, third and sixth months after renal transplantation were measured. The mean serum anti-HEV IgG titers in the study participants was 1.36 (range 0.23 to 6.3). Twenty-three patients were found to be seropositive for HEV Ab defined as anti-HEV IgG titer > 1.1. The difference in liver and renal function tests (creatinine, eGFR, AST, ALT and ALP) at different intervals was not significant between patients with HEV Ab titers higher and lower than 1.1 (p > 0.05). However, an inverse correlation was observed between HEV Ab and eGFR values in the first (p = 0.047, r = -0.21), third (p = 0.04, r = -0.20) and sixth (p = 0.04, r = -0.22) months after renal transplantation in patients with HEV Ab < 1.1 but not in the subgroup with HEV Ab > 1.1. Also, a significant correlation between age and HEV Ab levels was found in the entire study population (p = 0.001, r = 0.33). Our findings showed a high prevalence of seropositivity for anti-HEV IgG in patients receiving renal transplants. However, liver and renal functions were not found to be significantly different seropositive and seronegative patients by up to 6 months post-transplantation.
虽然戊型肝炎病毒(HEV)引发急性肝炎广为人知,但有报告显示,HEV也可能导致接受器官移植的患者从急性肝炎发展为慢性肝炎和肝硬化。在本研究中,我们旨在评估肾移植患者中HEV的感染率。本研究招募了110名肾移植患者,并检测了肾移植后第1、3和6个月时的抗HEV IgG、肌酐、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)以及估计肾小球滤过率(eGFR)。研究参与者的血清抗HEV IgG平均滴度为1.36(范围为0.23至6.3)。23名患者抗HEV IgG滴度>1.1,被发现HEV抗体血清学阳性。HEV抗体滴度高于和低于1.1的患者在不同时间点的肝肾功能检查(肌酐、eGFR、AST、ALT和ALP)差异不显著(p>0.05)。然而,在肾移植后第1个月(p = 0.047,r = -0.21)、第3个月(p = 0.04,r = -0.20)和第6个月(p = 0.04,r = -0.22),HEV抗体<1.1的患者中,HEV抗体与eGFR值呈负相关,而在HEV抗体>1.1的亚组中未观察到这种相关性。此外,在整个研究人群中,年龄与HEV抗体水平之间存在显著相关性(p = 0.001,r = 0.33)。我们的研究结果显示,肾移植患者中抗HEV IgG血清学阳性率很高。然而,移植后长达6个月,血清学阳性和血清学阴性患者的肝肾功能未发现显著差异。