Characteristics of autochthonous hepatitis E virus infection in solid-organ transplant recipients in France.
BACKGROUND
Hepatitis E virus (HEV) infections can lead to chronic hepatitis in immunocompromised patients. We have investigated the risk factors for HEV infection among solid-organ transplant recipients and the characteristics of these infections.


METHODS
We performed serological tests, quantified the virus, and genotyped the virus in plasma samples. We performed a case-control study with HEV-infected patients and control participants matched for sex and age who were recruited from a population of solid-organ transplant recipients with no markers of HEV infection.


RESULTS
We investigated 38 consecutive cases of HEV genotype 3 infection. Twenty-two (58%) of these 38 patients developed a chronic infection. The acute-phase aminotransferase levels were higher in the patients who cleared the virus than in those who developed chronic infections. The anti-HEV immunoglobulin G and immunoglobulin M profiles and HEV RNA concentration in patients who cleared the virus were similar to those in patients who developed a chronic infection. A logistic regression analysis of 37 case patients and 148 control participants indicated that the only factor independently associated with HEV infection was the consumption of game meat (68% of case patients vs 47% of control participants; odds ratio, 2.32; 95% confidence interval, 1.04-5.15).


CONCLUSIONS
Immunocompromised patients should avoid eating insufficiently cooked game meat or pork products so as to reduce the risk of HEV infection and chronic liver disease.
Legrand-Abravanel
Florence
F
Institut National de la Santé et de la Recherche Médicale Unité 563, Centre de Physiopathologie de Toulouse Purpan, France.
Kamar
Nassim
N
Sandres-Saune
Karine
K
Garrouste
Cyril
C
Dubois
Martine
M
Mansuy
Jean-Michel
JM
Muscari
Fabrice
F
Sallusto
Federico
F
Rostaing
Lionel
L
Izopet
Jacques
J
D000328:Adult; D000368:Aged; D000818:Animals; D001717:Birds / Q000821:virology; D016022:Case-Control Studies; D002908:Chronic Disease; D005247:Feeding Behavior; D005260:Female; D005602:France / Q000453:epidemiology; D005838:Genotype; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000821:virology*; D016752:Hepatitis E virus / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008460:Meat / Q000821:virology; D008875:Middle Aged; D008969:Molecular Sequence Data; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D012307:Risk Factors; D017422:Sequence Analysis, DNA; D013552:Swine / Q000821:virology; D019737:Transplants / Q000009:adverse effects*
D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral