Hepatitis E and Allogeneic Hematopoietic Stem Cell Transplantation: A French Nationwide SFGM-TC Retrospective Study.

Abstract

Usually self-limited, hepatitis E virus (HEV) infection may evolve to chronicity and cirrhosis in immunosuppressed patients. HEV infection has been described in solid-organ transplantation and hematology patients, but for allogeneic hematopoietic stem cell transplant (alloHSCT) recipients, only small cohorts are available. This retrospective nationwide multi-center series aimed to describe HEV diagnostic practices in alloHSCT French centers, and the course of infection in the context of alloHSCT. Twenty-nine out of 37 centers participated. HEV search in case of liver function tests (LFT) abnormalities was never performed in 24% of centers, occasionally in 55%, and systematically in 21%. Twenty-five cases of active HEV infection were diagnosed in seven centers, all because of LFT abnormalities, by blood nucleic acid testing. HEV infection was diagnosed in three patients before alloHSCT; HEV infection did not influence transplantation planning, and resolved spontaneously before or after alloHSCT. Twenty-two patients were diagnosed a median of 283 days after alloHSCT. Nine patients (41%) had spontaneous viral clearance, mostly after immunosuppressive treatment decrease. Thirteen patients (59%) received ribavirin, with sustained viral clearance in 11/12 evaluable patients. We observed three HEV recurrences but no HEV-related death or liver failure, nor evolution to cirrhosis.

• Authors: Aliénor Xhaard, Anne-Marie Roque-Afonso, Vincent Mallet, Patricia Ribaud, Stéphanie Nguyen-Quoc, Pierre-Simon Rohrlich, Reza Tabrizi, Johanna Konopacki, Séverine Lissandre, Florence Abravanel, Régis Peffault de Latour, Anne Huynh
• Journal: Viruses (Viruses) Vol. 11 Issue 7 (07 05 2019) ISSN: 1999-4915 [Electronic] Switzerland
• PMID: 31284515 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Immunosuppressive Agents
• Ribavirin

Topics

• Adult
• Aged
• Female
• France (epidemiology)
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Hepatitis E (diagnosis, epidemiology, immunology, therapy)
• Hepatitis E virus (immunology, isolation & purification)
• Humans
• Immunosuppressive Agents (adverse effects)
• Liver (pathology, physiopathology)
• Male
• Middle Aged
• Retrospective Studies
• Ribavirin (therapeutic use)
• Treatment Outcome
• Young Adult