title: Hepatitis E in three immunocompromized children in southeastern France.
abstract: Hepatitis E virus (HEV) causes an emerging autochthonous disease in developed countries where links with a viral porcine reservoir have been evidenced. Moreover, chronic HEV infection and associated-cirrhosis have been described in severely immunocompromized patients. Nonetheless, only few studies have focused on pediatric HEV infections worldwide and only four autochthonous cases have been reported in children in developed countries. We describe here acute hepatitis E in three immunocompromized children. Case no. 1 was a 9-year-old liver transplant recipient girl in whom H1N1 2009 flu infection was diagnosed concurrently with hepatitis E. Case no. 2 was a 12-year-old boy presenting early medullar relapse of lymphoblastic leukemia of type B and in whom HEV RNA was detected over a 29-week period. Case no. 3 was a 9-year-old boy with a rare primary immunodeficiency due to XIAP deficiency. HEV infections were all autochthonously acquired and involved different viruses classified as subtype f, c, and e of genotype 3, which are those described in autochthonous cases in Europe. These three observations prompt to consider HEV as a causative agent of hepatitis in children in developed countries, and to perform particularly HEV testing in those severely immunocompromized who may develop chronic hepatitis E.
authors.affiliation: Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Centre Hospitalo-Universitaire Timone, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Motte
authors.forename: Bertrand
authors.initials: B
authors.lastname: Roquelaure
authors.forename: Claire
authors.initials: C
authors.lastname: Galambrun
authors.forename: Fanette
authors.initials: F
authors.lastname: Bernard
authors.forename: Christine
authors.initials: C
authors.lastname: Zandotti
authors.forename: Philippe
authors.initials: P
authors.lastname: Colson
mesh_terms: D002648:Child; D060085:Coinfection / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D005260:Female; D005602:France / Q000453:epidemiology; D016751:Hepatitis E / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D016752:Hepatitis E virus / Q000145:classification / Q000235:genetics*; D006801:Humans; D016867:Immunocompromised Host; D007153:Immunologic Deficiency Syndromes / Q000150:complications / Q000453:epidemiology; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications / Q000453:epidemiology / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D010802:Phylogeny; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000453:epidemiology; D017422:Sequence Analysis, DNA; D051636:X-Linked Inhibitor of Apoptosis Protein / Q000172:deficiency
chemical_list: D051636:X-Linked Inhibitor of Apoptosis Protein; C496866:XIAP protein, human