title: Paediatric liver transplanted patients and prevalence of hepatitis E virus.
abstract: BACKGROUND
  Hepatitis E is an emerging disease in developed countries and is usually asymptomatic, particularly in children. Chronic infection is possible in immunocompromised individuals. In the context of a liver transplant, it can simulate a rejection. In this case, antiviral therapy may be considered, thus highlighting the need to diagnose hepatitis E virus (HEV) infection in this population.
  
  
  OBJECTIVE
  Given the lack of data in France, we have studied the the prevalence of antibodies to HEV in the paediatric liver transplant population.
  
  
  METHODS
  This was a retrospective study, carried out in Lyon between 1st January 2010 and 31 May 2013. HEV serology (anti-HEV IgM &IgG) and HEV PCR were studied in 96 children who had undergone liver transplants (84 isolated liver and 12 combined liver and kidney transplants).
  
  
  RESULTS
  Eight patients (8.3%; 62.5% girls; mean age:12.3 years) were HEV seropositive. The mean period since their transplantation was 10 years (range:2-21.8 years). Biliary atresia was the principal indication for transplantation. Seven of these eight children had received liver transplants. There were no differences between the epidemiological and clinical data concerning these patients and the remainder of the study population, particularly with respect to immunosuppression(7/8 tacrolimus; 50% dual immunosuppression). No cases of chronic hepatitis E were found, but 1/8 had chronic cytolysis(EBV&adenovirus infection). In all the patients tested(4/8), seroconversion had occurred after the transplant. There was no significant differences between the age groups in this study.
  
  
  CONCLUSIONS
  This study showed that in France, the prevalence of antibodies to HEV in paediatric liver and combined liver and kidney transplant patients is 8.3%, as has been found by other European authors.
authors.affiliation: Service d'Hépato-gastroentérologie et nutrition pédiatrique, Hôpital Femme Mère Enfant, 59 bd Pinel, 69500 Bron, France. Electronic address: noemie.laverdure@free.fr.
authors.forename: N
authors.initials: N
authors.lastname: Laverdure
authors.affiliation: Service de Virologie, Hôpital de la Croix Rousse, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Scholtès-Brunel
authors.affiliation: Service d'Hépato-gastroentérologie et nutrition pédiatrique, Hôpital Femme Mère Enfant, 59 bd Pinel, 69500 Bron, France.
authors.forename: C
authors.initials: C
authors.lastname: Rivet
authors.affiliation: Service d'Hépato-gastroentérologie et nutrition pédiatrique, Hôpital Femme Mère Enfant, 59 bd Pinel, 69500 Bron, France.
authors.forename: S
authors.initials: S
authors.lastname: Heissat
authors.affiliation: Service d'Hépato-gastroentérologie et nutrition pédiatrique, Hôpital Femme Mère Enfant, 59 bd Pinel, 69500 Bron, France.
authors.forename: L
authors.initials: L
authors.lastname: Restier
authors.affiliation: Service de Néphrologie Pédiatrique, Hôpital Femme Mère Enfant, 59 bd Pinel, 69500 Bron, France.
authors.forename: J
authors.initials: J
authors.lastname: Bacchetta
authors.affiliation: Service de Chirurgie Viscérale, Hôpital Edouard Herriot, Pavillon D, 5 place d'Arsonval, 69003 Lyon, France.
authors.forename: O
authors.initials: O
authors.lastname: Boillot
authors.affiliation: Service d'Hépato-gastroentérologie, Hôpital Édouard Herriot, Pavillon H, 5 place d'Arsonval, 69003 Lyon, France.
authors.forename: J
authors.initials: J
authors.lastname: Dumortier
authors.affiliation: Service d'Hépato-gastroentérologie et nutrition pédiatrique, Hôpital Femme Mère Enfant, 59 bd Pinel, 69500 Bron, France.
authors.forename: A
authors.initials: A
authors.lastname: Lachaux
mesh_terms: D000293:Adolescent; D000328:Adult; D001656:Biliary Atresia; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D016752:Hepatitis E virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006521:Hepatitis, Chronic / Q000821:virology; D006801:Humans; D007165:Immunosuppression Therapy; D007223:Infant; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D013997:Time Factors; D066027:Transplant Recipients / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D006508:Hepatitis Antibodies; D012367:RNA, Viral
keywords: HEV infection; Hepatitis E; Pediatric transplantation; Prevalence