title: Chronic Infection With Camelid Hepatitis E Virus in a Liver Transplant Recipient Who Regularly Consumes Camel Meat and Milk.
abstract: There have been increasing reports of food-borne zoonotic transmission of hepatitis E virus (HEV) genotype 3, which causes chronic infections in immunosuppressed patients. We performed phylogenetic analyses of the HEV sequence (partial and full-length) from 1 patient from the Middle East who underwent liver transplantation, and compared it with other orthohepevirus A sequences. We found the patient to be infected by camelid HEV. This patient regularly consumed camel meat and milk, therefore camelid HEV, which is genotype 7, might infect human beings. Our finding links consumption of camel-derived food products to post-transplantation hepatitis E, which, if detected at early stages, can be cured with antiviral therapy and reduced administration of immunosuppressive agents.
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Medicine, National University Health System, Singapore; National University Centre for Organ Transplantation, National University Hospital, Singapore. Electronic address: mdcleegh@nus.edu.sg.
authors.forename: Guan-Huei
authors.initials: GH
authors.lastname: Lee
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
authors.forename: Boon-Huan
authors.initials: BH
authors.lastname: Tan
authors.affiliation: Department of Hematology, Singapore General Hospital, Singapore.
authors.forename: Esmeralda Chi-Yuan
authors.initials: EC
authors.lastname: Teo
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Medicine, National University Health System, Singapore; National University Centre for Organ Transplantation, National University Hospital, Singapore.
authors.forename: Seng-Gee
authors.initials: SG
authors.lastname: Lim
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Medicine, National University Health System, Singapore; National University Centre for Organ Transplantation, National University Hospital, Singapore.
authors.forename: Yock-Young
authors.initials: YY
authors.lastname: Dan
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Pathology, National University Health System, Singapore.
authors.forename: Aileen
authors.initials: A
authors.lastname: Wee
authors.affiliation: Genome Institute of Singapore, Singapore.
authors.forename: Pauline Poh Kim
authors.initials: PP
authors.lastname: Aw
authors.affiliation: Genome Institute of Singapore, Singapore.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Genome Institute of Singapore, Singapore; London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Martin Lloyd
authors.initials: ML
authors.lastname: Hibberd
authors.affiliation: Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore; Duke-NUS Graduate Medical School, Singapore.
authors.forename: Chee-Kiat
authors.initials: CK
authors.lastname: Tan
authors.affiliation: Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Purdy
authors.affiliation: Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Chong-Gee
authors.initials: CG
authors.lastname: Teo
mesh_terms: D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use; D002162:Camelus / Q000821:virology*; D005506:Food Contamination; D005838:Genotype; D016751:Hepatitis E / Q000175:diagnosis / Q000188:drug therapy / Q000635:transmission / Q000821:virology*; D016752:Hepatitis E virus / Q000235:genetics / Q000472:pathogenicity*; D006521:Hepatitis, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008460:Meat / Q000821:virology*; D008875:Middle Aged; D008892:Milk / Q000821:virology*; D010802:Phylogeny; D013997:Time Factors; D016896:Treatment Outcome; D015047:Zoonoses
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents
keywords: Case Study; Liver Disease; Viral Infection; Zoonosis