title: Hepatitis E Virus Infection Among Solid Organ Transplant Recipients at a North American Transplant Center.
abstract: Background.  Autochthonous hepatitis E virus (HEV) infection has been reported in over 200 solid organ transplant (SOT) recipients since 2006, yet little is known about the burden of HEV among SOT recipients in North America. We performed a retrospective, cross-sectional study to investigate the prevalence and risk factors associated with HEV infection among SOT recipients at our institution. Methods.  Children and adults (n = 311) who received allografts between 1988 and 2012 at the Johns Hopkins Hospital were assessed for evidence of HEV infection by testing posttransplantation serum samples for HEV antibody by enzyme immunoassay and HEV RNA by reverse transcription quantitative polymerase chain reaction. Individuals with evidence of posttransplant HEV infection (presence of anti-HEV immunoglobulin [Ig]M antibody, anti-HEV IgG seroconversion, or HEV RNA) were compared with individuals without evidence of infection and assessed for risk factors associated with infection. Results.  Twelve individuals (4%) developed posttransplant HEV infection. Posttransplant HEV infection was associated with an increased risk for graft rejection (odds ratio, 14.2; P = .03). No individuals developed chronic infection. Conclusions.  Solid organ transplant recipients in the United States are at risk for posttransplant HEV infection. Further studies are needed to characterize environmental risk factors and the risk of HEV infection after SOT in North America.
authors.affiliation: Department of Pediatrics, Division of Pediatric Infectious Diseases, The Johns Hopkins University School of Medicine,; Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Paul K
authors.initials: PK
authors.lastname: Sue
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health.
authors.forename: Nora
authors.initials: N
authors.lastname: Pisanic
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health,; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Heaney
authors.affiliation: Department of Pathology, Division of Medical Microbiology.
authors.forename: Michael
authors.initials: M
authors.lastname: Forman
authors.affiliation: Department of Pathology, Division of Medical Microbiology.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Valsamakis
authors.affiliation: Department of Immunology, Division of Immunogenetics.
authors.forename: Annette M
authors.initials: AM
authors.lastname: Jackson
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health,; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health.
authors.forename: John R
authors.initials: JR
authors.lastname: Ticehurst
authors.affiliation: Department of Surgery, Division of Transplantation Surgery, and.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Montgomery
authors.affiliation: Department of Pediatrics, Division of Pediatric Gastroenterology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; and.
authors.forename: Kathleen B
authors.initials: KB
authors.lastname: Schwarz
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health.
authors.forename: Kenrad E
authors.initials: KE
authors.lastname: Nelson
authors.affiliation: Department of Pediatrics, Division of Pediatric Gastroenterology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; and.
authors.forename: Wikrom
authors.initials: W
authors.lastname: Karnsakul
keywords: hepatitis E virus; renal transplantation; solid organ transplantation; viral hepatitis