title: Low risk of hepatitis E virus reactivation after haematopoietic stem cell transplantation.
abstract: BACKGROUND
  Hepatitis E virus (HEV) is an emerging cause of acute hepatitis in industrialized countries. HEV infection can evolve to chronic hepatitis in immunocompromised patients. Additionally, HEV reactivation after haematopoietic stem cell transplantation has been reported.
  
  
  OBJECTIVE
  To assess the prevalence of anti-HEV antibodies in patients who underwent haematopoietic stem cell transplantation in south-western France and the risk of HEV reactivation after transplantation.
  
  
  METHODS
  We have investigated the prevalence of anti-HEV antibodies in 88 patients who underwent allogenic or autologous haematopoietic stem cell transplantation with two anti-HEV IgG assays and have evaluated the risk of HEV reactivation in pretransplant seropositive patients by testing for HEV RNA in blood samples collected after stem cell transplantation.
  
  
  RESULTS
  While only 11 patients (12.5%) tested positive for anti-HEV IgG with the Adaltis assay, 32 patients (36.4%) tested positive for anti-HEV IgG with the Wantai assay before transplantation. Three anti-HEV IgG positive patients were also anti-HEV IgM positive. Plasma HEV RNA was negative in all the patients before transplantation. We looked for HEV reactivation in pretransplant seropositive patients by testing 89 blood samples for HEV RNA 1, 3 and 6 months after transplantation. We detected no reactivation. Similarly, we detected no HEV RNA in pretransplant seronegative patients after transplantation.
  
  
  CONCLUSIONS
  Despite strong immunosuppression, the risk of HEV reactivation after stem cell transplantation appears to be very low.
authors.affiliation: INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300 France. abravanel.f@chu-toulouse.fr
authors.forename: Florence
authors.initials: F
authors.lastname: Abravanel
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Mansuy
authors.forename: Anne
authors.initials: A
authors.lastname: Huynh
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
authors.forename: Laurent
authors.initials: L
authors.lastname: Alric
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Peron
authors.forename: Christian
authors.initials: C
authors.lastname: Récher
authors.forename: Jacques
authors.initials: J
authors.lastname: Izopet
mesh_terms: D000328:Adult; D005260:Female; D005602:France / Q000453:epidemiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000453:epidemiology*; D016752:Hepatitis E virus / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D018570:Risk Assessment; D014775:Virus Activation
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D012367:RNA, Viral