Rat hepatitis E virus as cause of persistent hepatitis after liver transplant

Siddharth Sridhar; Cyril C.Y. Yip; Shusheng Wu; Jianpiao Cai; Anna Jin Xia Zhang; Kit Hang Leung; Tom W.H. Chung; Jasper F.W. Chan; Wan Mui Chan; Jade L.L. Teng; Rex K.H. Au-Yeung; Vincent C.C. Cheng; Honglin Chen; Susanna K.P. Lau; Patrick C.Y. Woo; Ning Shao Xia; Chung Mau Lo; Kwok Yung Yuen

doi:10.3201/eid2412.180937

Rat hepatitis E virus as cause of persistent hepatitis after liver transplant

Siddharth Sridhar, Cyril C.Y. Yip, Shusheng Wu, Jianpiao Cai, Anna Jin Xia Zhang, Kit Hang Leung, Tom W.H. Chung, Jasper F.W. Chan, Wan Mui Chan, Jade L.L. Teng, Rex K.H. Au-Yeung, Vincent C.C. Cheng, Honglin Chen, Susanna K.P. Lau, Patrick C.Y. Woo, Ning Shao Xia, Chung Mau Lo, Kwok Yung Yuen

Research output: Contribution to journal › Article › peer-review

192 Citations (Scopus)

Abstract

All hepatitis E virus (HEV) variants reported to infect humans belong to the species Orthohepevirus A (HEV-A). The zoonotic potential of the species Orthohepevirus C (HEV-C), which circulates in rats and is highly divergent from HEV-A, is unknown. We report a liver transplant recipient with hepatitis caused by HEV-C infection. We detected HEV-C RNA in multiple clinical samples and HEV-C antigen in the liver. The complete genome of the HEV-C isolate had 93.7% nt similarity to an HEV-C strain from Vietnam. The patient had preexisting HEV antibodies, which were not protective against HEV-C infection. Ribavirin was an effective treatment, resulting in resolution of hepatitis and clearance of HEV-C viremia. Testing for this zoonotic virus should be performed for immunocompromised and immunocompetent patients with unexplained hepatitis because routine hepatitis E diagnostic tests may miss HEV-C infection. HEV-C is also a potential threat to the blood product supply.

Original language	English
Pages (from-to)	2241-2250
Number of pages	10
Journal	Emerging Infectious Diseases
Volume	24
Issue number	12
DOIs	https://doi.org/10.3201/eid2412.180937
Publication status	Published - Dec 2018
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2018, Centers for Disease Control and Prevention (CDC). All rights reserved.

ASJC Scopus Subject Areas

Epidemiology
Microbiology (medical)
Infectious Diseases

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Sridhar, S., Yip, C. C. Y., Wu, S., Cai, J., Zhang, A. J. X., Leung, K. H., Chung, T. W. H., Chan, J. F. W., Chan, W. M., Teng, J. L. L., Au-Yeung, R. K. H., Cheng, V. C. C., Chen, H., Lau, S. K. P., Woo, P. C. Y., Xia, N. S., Lo, C. M., & Yuen, K. Y. (2018). Rat hepatitis E virus as cause of persistent hepatitis after liver transplant. Emerging Infectious Diseases, 24(12), 2241-2250. https://doi.org/10.3201/eid2412.180937

Sridhar, S, Yip, CCY, Wu, S, Cai, J, Zhang, AJX, Leung, KH, Chung, TWH, Chan, JFW, Chan, WM, Teng, JLL, Au-Yeung, RKH, Cheng, VCC, Chen, H, Lau, SKP, Woo, PCY, Xia, NS, Lo, CM & Yuen, KY 2018, 'Rat hepatitis E virus as cause of persistent hepatitis after liver transplant', Emerging Infectious Diseases, vol. 24, no. 12, pp. 2241-2250. https://doi.org/10.3201/eid2412.180937

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abstract = "All hepatitis E virus (HEV) variants reported to infect humans belong to the species Orthohepevirus A (HEV-A). The zoonotic potential of the species Orthohepevirus C (HEV-C), which circulates in rats and is highly divergent from HEV-A, is unknown. We report a liver transplant recipient with hepatitis caused by HEV-C infection. We detected HEV-C RNA in multiple clinical samples and HEV-C antigen in the liver. The complete genome of the HEV-C isolate had 93.7% nt similarity to an HEV-C strain from Vietnam. The patient had preexisting HEV antibodies, which were not protective against HEV-C infection. Ribavirin was an effective treatment, resulting in resolution of hepatitis and clearance of HEV-C viremia. Testing for this zoonotic virus should be performed for immunocompromised and immunocompetent patients with unexplained hepatitis because routine hepatitis E diagnostic tests may miss HEV-C infection. HEV-C is also a potential threat to the blood product supply.",

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AU - Cheng, Vincent C.C.

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AU - Lau, Susanna K.P.

AU - Woo, Patrick C.Y.

AU - Xia, Ning Shao

AU - Lo, Chung Mau

AU - Yuen, Kwok Yung

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AB - All hepatitis E virus (HEV) variants reported to infect humans belong to the species Orthohepevirus A (HEV-A). The zoonotic potential of the species Orthohepevirus C (HEV-C), which circulates in rats and is highly divergent from HEV-A, is unknown. We report a liver transplant recipient with hepatitis caused by HEV-C infection. We detected HEV-C RNA in multiple clinical samples and HEV-C antigen in the liver. The complete genome of the HEV-C isolate had 93.7% nt similarity to an HEV-C strain from Vietnam. The patient had preexisting HEV antibodies, which were not protective against HEV-C infection. Ribavirin was an effective treatment, resulting in resolution of hepatitis and clearance of HEV-C viremia. Testing for this zoonotic virus should be performed for immunocompromised and immunocompetent patients with unexplained hepatitis because routine hepatitis E diagnostic tests may miss HEV-C infection. HEV-C is also a potential threat to the blood product supply.

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Rat hepatitis E virus as cause of persistent hepatitis after liver transplant

Abstract

Bibliographical note

ASJC Scopus Subject Areas

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