title: First report and molecular characterization of hepatitis E virus infection in renal transplant recipients in Brazil.
abstract: Hepatitis E virus (HEV) causes acute and chronic hepatitis in organ transplant recipients. Serological evidence for HEV infection has been discovered in various population groups in Brazil, and a single acute case has been confirmed. To date, however, no cases of HEV infection in immunocompromised patients have been reported in Brazil. This study aimed to identify and characterize hepatitis E cases in renal transplant recipients in Brazil. A retrospective study was performed on 96 serum samples from renal transplant recipients with unexplained liver enzymes elevation. Three confirmed cases of HEV infection were identified that lacked seroconversion to HEV IgG antibodies. The prevalence of HEV in these patients was 3.1%. Using a sequence analysis of a 304-nucleotide fragment within ORF2, the strains were classified as genotype 3 with a low percent identity to previously characterized strains. This is the first report of hepatitis E infection in renal transplant recipients in Brazil, and the data indicate that a novel genotype 3 subvariant may be present and that further investigation is necessary to characterize the circulating HEV strains. In this setting, HEV infection should be considered as a potential cause of abnormal liver tests of unknown origin.
authors: Division of Infectious Diseases, Federal University of Sao Paulo, Sao Paulo, Brazil. anampassos@gmail.com
authors: Ana Maria
authors: AM
authors: Passos
authors: Tiago Pires
authors: TP
authors: Heringer
authors: José Osmar
authors: JO
authors: Medina-Pestana
authors: Maria Lucia Gomes
authors: ML
authors: Ferraz
authors: Celso Francisco Hernandes
authors: CF
authors: Granato
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D005260:Female; D005838:Genotype; D016751:Hepatitis E / Q000453:epidemiology* / Q000821:virology; D016752:Hepatitis E virus / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics; D012189:Retrospective Studies; D017422:Sequence Analysis, DNA; D014180:Transplantation
chemical_list: D012367:RNA, Viral