Donor-derived genotype 4 hepatitis E virus infection, Hong Kong, China, 2018

Siddharth Sridhar; Vincent C.C. Cheng; Shuk Ching Wong; Cyril C.Y. Yip; Shusheng Wu; Anthony W.I. Lo; Kit Hang Leung; Winger W.N. Mak; Jianpiao Cai; Xin Li; Jasper F.W. Chan; Susanna K.P. Lau; Patrick C.Y. Woo; Wai Ming Lai; Tze Hoi Kwan; Timmy W.K. Au; Chung Mau Lo; Sally C.Y. Wong; Kwok Yung Yuen

doi:10.3201/eid2503.181563

Donor-derived genotype 4 hepatitis E virus infection, Hong Kong, China, 2018

Siddharth Sridhar, Vincent C.C. Cheng, Shuk Ching Wong, Cyril C.Y. Yip, Shusheng Wu, Anthony W.I. Lo, Kit Hang Leung, Winger W.N. Mak, Jianpiao Cai, Xin Li, Jasper F.W. Chan, Susanna K.P. Lau, Patrick C.Y. Woo, Wai Ming Lai, Tze Hoi Kwan, Timmy W.K. Au, Chung Mau Lo, Sally C.Y. Wong, Kwok Yung Yuen

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33 Citations (Scopus)

Abstract

Hepatitis E virus (HEV) genotype 4 (HEV-4) is an emerging cause of acute hepatitis in China. Less is known about the clinical characteristics and natural history of HEV-4 than HEV genotype 3 infections in immunocompromised patients. We report transmission of HEV-4 from a deceased organ donor to 5 transplant recipients. The donor had been viremic but HEV IgM and IgG seronegative, and liver function test results were within reference ranges. After a mean of 52 days after transplantation, hepatitis developed in all 5 recipients; in the liver graft recipient, disease was severe and with progressive portal hypertension. Despite reduced immunosuppression, all HEV-4 infections progressed to persistent hepatitis. Four patients received ribavirin and showed evidence of response after 2 months. This study highlights the role of organ donation in HEV transmission, provides additional data on the natural history of HEV-4 infection, and points out differences between genotype 3 and 4 infections in immunocompromised patients.

Original language	English
Pages (from-to)	425-433
Number of pages	9
Journal	Emerging Infectious Diseases
Volume	25
Issue number	3
DOIs	https://doi.org/10.3201/eid2503.181563
Publication status	Published - Mar 2019
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2019, Centers for Disease Control and Prevention (CDC). All rights reserved.

ASJC Scopus Subject Areas

Epidemiology
Microbiology (medical)
Infectious Diseases

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Cite this

Sridhar, S., Cheng, V. C. C., Wong, S. C., Yip, C. C. Y., Wu, S., Lo, A. W. I., Leung, K. H., Mak, W. W. N., Cai, J., Li, X., Chan, J. F. W., Lau, S. K. P., Woo, P. C. Y., Lai, W. M., Kwan, T. H., Au, T. W. K., Lo, C. M., Wong, S. C. Y., & Yuen, K. Y. (2019). Donor-derived genotype 4 hepatitis E virus infection, Hong Kong, China, 2018. Emerging Infectious Diseases, 25(3), 425-433. https://doi.org/10.3201/eid2503.181563

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abstract = "Hepatitis E virus (HEV) genotype 4 (HEV-4) is an emerging cause of acute hepatitis in China. Less is known about the clinical characteristics and natural history of HEV-4 than HEV genotype 3 infections in immunocompromised patients. We report transmission of HEV-4 from a deceased organ donor to 5 transplant recipients. The donor had been viremic but HEV IgM and IgG seronegative, and liver function test results were within reference ranges. After a mean of 52 days after transplantation, hepatitis developed in all 5 recipients; in the liver graft recipient, disease was severe and with progressive portal hypertension. Despite reduced immunosuppression, all HEV-4 infections progressed to persistent hepatitis. Four patients received ribavirin and showed evidence of response after 2 months. This study highlights the role of organ donation in HEV transmission, provides additional data on the natural history of HEV-4 infection, and points out differences between genotype 3 and 4 infections in immunocompromised patients.",

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N2 - Hepatitis E virus (HEV) genotype 4 (HEV-4) is an emerging cause of acute hepatitis in China. Less is known about the clinical characteristics and natural history of HEV-4 than HEV genotype 3 infections in immunocompromised patients. We report transmission of HEV-4 from a deceased organ donor to 5 transplant recipients. The donor had been viremic but HEV IgM and IgG seronegative, and liver function test results were within reference ranges. After a mean of 52 days after transplantation, hepatitis developed in all 5 recipients; in the liver graft recipient, disease was severe and with progressive portal hypertension. Despite reduced immunosuppression, all HEV-4 infections progressed to persistent hepatitis. Four patients received ribavirin and showed evidence of response after 2 months. This study highlights the role of organ donation in HEV transmission, provides additional data on the natural history of HEV-4 infection, and points out differences between genotype 3 and 4 infections in immunocompromised patients.

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Donor-derived genotype 4 hepatitis E virus infection, Hong Kong, China, 2018

Abstract

Bibliographical note

ASJC Scopus Subject Areas

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