Prevalence of hepatitis E virus infection in pediatric solid organ transplant recipients--a single-center experience.
HEV infection appears to be an emerging disease in industrialized countries. The aim of this study was to evaluate the prevalence of HEV infection in pediatric solid organ transplant recipients. One hundred and twenty-four pediatric recipients of liver (n = 41) or kidney (n = 83) transplants aged between one and 18 yr were screened for anti-HEV IgG antibodies. Patients were tested for fecal HEV RNA excretion if they showed anti-HEV seropositivity. As a control group, 108 immunocompetent pediatric patients without liver disease aged between three and 18 yr were screened for anti-HEV IgG. HEV seroprevalence was 2.4% in renal Tx (2/83), 4.9% in liver Tx patients (2/41), and 3.2% overall (4/124). Three of these four patients were HEV RNA-negative. In one renal transplant patient, HEV genotype 3 RNA excretion persisted and liver enzymes were elevated, indicating chronic hepatitis. In the control group, eight patients (7.4%) were HEV IgG-positive without biochemical evidence of hepatitis. The prevalence of HEV infection in pediatric renal or liver transplant recipients is not higher compared with immunocompetent children. Chronic HEV infection with long-term carriage of the virus may develop in pediatric transplant recipients. Autochthonous HEV infection needs to be considered in uncertain cases of hepatitis in immunosuppressed as well as immunocompetent children.
Pediatrics II, Department for Pediatric Nephrology, Gastroenterology, Endocrinology and Transplant Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
André
A
Hoerning
Bianca
B
Hegen
Anne-Margret
AM
Wingen
Metin
M
Cetiner
Elke
E
Lainka
Simone
S
Kathemann
Melanie
M
Fiedler
Jörg
J
Timm
Jürgen J
JJ
Wenzel
Peter F
PF
Hoyer
Patrick
P
Gerner
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D016751:Hepatitis E / Q000150:complications / Q000453:epidemiology*; D016752:Hepatitis E virus / Q000378:metabolism*; D006801:Humans; D007074:Immunoglobulin G / Q000737:chemistry; D007165:Immunosuppression Therapy; D007223:Infant; D016030:Kidney Transplantation / Q000379:methods*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D015995:Prevalence; D012367:RNA, Viral / Q000378:metabolism; D016036:Seroepidemiologic Studies; D014180:Transplantation / Q000009:adverse effects*; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D007074:Immunoglobulin G; D012367:RNA, Viral