4th Medical Department,Aristotle University of Thessaloniki, Hippokratio Hospital,Thessaloniki,Greece.
Microbiology Department,Medical School, Aristotle University of Thessaloniki,Thessaloniki,Greece.
Epidemiol Infect. 2018 Oct;146(13):1619-1621. doi: 10.1017/S0950268818001887. Epub 2018 Jul 5.
Hepatitis E virus (HEV) is a well-known cause of acute hepatitis. Immunocompromised subjects, including liver transplant recipients, are considered to be at risk for HEV infection, which occasionally follows a chronic course. The diagnosis of HEV infection in these patients must be based on HEV RNA testing, as serology has variable performance. The aim of this study was to assess the prevalence of HEV infection in liver transplant recipients in Greece by means of HEV RNA testing. Liver transplant recipients followed in the sole transplant centre in Greece were prospectively included. HEV RNA was detected by real-time RT-PCR. Positive samples were further analysed using a nested reverse transcription RT-PCR kit, which amplifies a 137-nucleotide sequence within the ORF2/ORF3 overlapping region to detect the HEV genotype and perform phylogenetic analysis. The mean age of the included patients (n = 76) was 54 years. The most common indication for liver transplantation was viral hepatitis (57%). The majority of the patients (75%) received a calcineurin inhibitor as part of their immunosuppressive regimen and had normal liver enzymes. HEV RNA was found positive in only 1/76 (1.3%) patient. Phylogenetic analysis showed that the sequence clustered into the HEV genotype 3 clade. This patient experienced an acute hepatitis flare, which nonetheless did not become chronic. The prevalence of HEV infection in liver transplant recipients in Greece is similar (1.3%) to that reported previously in other countries. Transplant physicians should be aware of this condition and its associated consequences.
戊型肝炎病毒 (HEV) 是引起急性肝炎的已知原因。免疫功能低下的患者，包括肝移植受者，被认为有感染 HEV 的风险，其感染偶尔呈慢性病程。这些患者的 HEV 感染诊断必须基于 HEV RNA 检测，因为血清学检测的性能存在差异。本研究旨在通过 HEV RNA 检测评估希腊肝移植受者中 HEV 感染的流行率。希腊唯一的移植中心前瞻性纳入了随访的肝移植受者。通过实时 RT-PCR 检测 HEV RNA。使用巢式逆转录 RT-PCR 试剂盒进一步分析阳性样本，该试剂盒扩增 ORF2/ORF3 重叠区的 137 个核苷酸序列，以检测 HEV 基因型并进行系统进化分析。纳入患者（n=76）的平均年龄为 54 岁。肝移植的最常见适应证是病毒性肝炎（57%）。大多数患者（75%）接受钙调神经磷酸酶抑制剂作为其免疫抑制方案的一部分，且肝酶正常。仅在 1/76（1.3%）患者中发现 HEV RNA 阳性。系统进化分析显示该序列聚类到 HEV 基因型 3 分支。该患者发生急性肝炎发作，但并未转为慢性。希腊肝移植受者中 HEV 感染的流行率（1.3%）与先前在其他国家报道的相似。移植医生应了解这种情况及其相关后果。
