Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Arch Iran Med. 2021 Jan 1;24(1):22-26. doi: 10.34172/aim.2021.04.
Chronic hepatitis E infection has been reported in solid organ transplant recipients following acute hepatitis due to the compromised immune status. Almost all reports are from areas where hepatitis E virus (HEV) genotypes 3 and 4 are the dominant genotypes. This study was conducted to investigate the role of hepatitis E infection as an etiology for liver enzymes elevation in liver transplant recipients from the largest liver transplant program in Iran.
In a prospective study from June to December 2015, in a single liver transplantation center in Iran, all adult liver recipients who were investigated for the etiology of persistent elevation of liver enzymes were tested for HEV serology status.
Of 122 patients included in the study, 19 (15.6%) were positive for HEV serology. Seropositive patients were significantly older than seronegative ones (mean age 43.79 vs. 31.58, P < 0.001); however, they were not different in other characteristics including sex distribution and mean of liver enzymes in each occasion. Liver biopsies were done in 16 HEV seropositive patients and none of the biopsies showed evidence for acute or chronic viral hepatitis.
In this study, with 15.6% rate of HEV seropositivity in liver recipients with persistent elevation of liver enzymes, we were not able to confirm any clinical evidence for active acute or chronic hepatitis E infection. This could theoretically be attributed to the fact that the dominant prevalent HEV genotype in our endemic area is not associated with a chronic form of infection.
在因免疫功能受损而发生急性肝炎的实体器官移植受者中，已有慢性戊型肝炎感染的报道。几乎所有的报道都来自于戊型肝炎病毒（HEV）基因型 3 和 4 为主要基因型的地区。本研究旨在调查在伊朗最大的肝脏移植项目中，HEV 感染作为肝移植受者肝酶升高的病因的作用。
在 2015 年 6 月至 12 月进行的一项前瞻性研究中，在伊朗的一个单一肝脏移植中心，对所有因持续肝酶升高而接受病因检查的成年肝脏受者进行了 HEV 血清学检测。
在纳入研究的 122 例患者中，有 19 例（15.6%）HEV 血清学阳性。血清阳性患者明显比血清阴性患者年龄大（平均年龄 43.79 岁 vs. 31.58 岁，P < 0.001）；然而，在其他特征方面，包括性别分布和每次的肝酶平均值，两组之间无差异。对 16 例 HEV 血清阳性患者进行了肝活检，均未显示出急性或慢性病毒性肝炎的证据。
在本研究中，在持续肝酶升高的肝移植受者中，HEV 血清阳性率为 15.6%，我们无法证实任何活动性急性或慢性戊型肝炎感染的临床证据。这理论上可以归因于在我们的流行地区，主要流行的 HEV 基因型与慢性感染无关。
