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Factors associated with chronic hepatitis in patients with hepatitis E virus infection who have received solid organ transplants
- Source :
- Gastroenterology, Gastroenterology, WB Saunders, 2011, 140 (5), pp.1481-9. ⟨10.1053/j.gastro.2011.02.050⟩, Gastroenterology, 140(5), 1481-1489. W B SAUNDERS CO-ELSEVIER INC, Gastroenterology, WB Saunders, 2011, 140 (5), pp.1481-9. 〈10.1053/j.gastro.2011.02.050〉, Gastroenterology, 2011, 140 (5), pp.1481-9. ⟨10.1053/j.gastro.2011.02.050⟩
- Publication Year :
- 2011
- Publisher :
- HAL CCSD, 2011.
-
Abstract
- International audience; BACKGROUND & AIMS: Hepatitis E virus (HEV) infection can cause chronic hepatitis in recipients of solid organ transplants. However, the factors that contribute to chronic infection and the outcomes of these patients are incompletely understood. We performed a retrospective analysis of data from 17 centers from Europe and the United States that described the progression, outcomes, and factors associated with development of chronic HEV infection in recipients of transplanted solid organs. METHODS: We studied data from 85 recipients of solid organ transplants who were infected with HEV. Chronic HEV infection was defined by the persistent increases in levels of liver enzymes and polymerase chain reaction evidence of HEV in the serum and/or stool for at least 6 months. RESULTS: Fifty-six patients (65.9%) developed chronic hepatitis. Univariate analysis associated liver transplant, shorter times since transplant, lower levels of liver enzymes and serum creatinine, lower platelet counts, and tacrolimus-based immunosuppressive therapy (rather than cyclosporin A) with chronic hepatitis. On multivariate analysis, the independent predictive factors associated with chronic HEV infection were the use of tacrolimus rather than cyclosporin A (odds ratio [OR], 1.87; 95% confidence interval [CI], 1.49-1.97; P = .004) and a low platelet count at the time of diagnosis with HEV infection (OR, 1.02; 95% CI, 1.001-1.1; P = .04). Of patients with chronic hepatitis, 18 (32.1%) achieved viral clearance after the dose of immunosuppressive therapy was reduced. No HEV reactivation was observed after HEV clearance. CONCLUSIONS: HEV infection causes chronic hepatitis in more than 60% of recipients of solid organ transplants. Tacrolimus therapy is the main predictive factor for chronic hepatitis. Dose reductions of immunosuppressive therapy resulted in viral clearance in more than 30% of patients.
- Subjects :
- Male
MESH : Retrospective Studies
CYCLOSPORINE-A
medicine.medical_treatment
MESH : Aged
Liver transplantation
medicine.disease_cause
Polymerase Chain Reaction
MESH : Hepatitis E virus
THERAPY
Organ transplantation
MESH : Organ Transplantation
Liver disease
0302 clinical medicine
Hepatitis E virus
Cyclosporin a
MESH : Female
MESH: Incidence
MESH : Polymerase Chain Reaction
Hepatitis, Chronic
MESH: Aged
0303 health sciences
MESH: Middle Aged
Incidence
Liver Disease
Gastroenterology
MESH: Follow-Up Studies
Middle Aged
MESH : Adult
[SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences
LIVER-TRANSPLANTATION
MESH : Incidence
3. Good health
Hepatitis E
Virus
PREVALENCE
[SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences
Europe
MESH: Young Adult
BLOOD-DONORS
MESH: RNA, Viral
RNA, Viral
030211 gastroenterology & hepatology
Female
Adult
MESH: Hepatitis E virus
medicine.medical_specialty
MESH : United States
MESH : Male
MESH: Hepatitis, Chronic
MESH : Europe
MESH : Young Adult
FRANCE
MESH: Organ Transplantation
03 medical and health sciences
Young Adult
medicine
MESH: United States
Humans
MESH : RNA, Viral
MESH : Hepatitis, Chronic
MESH : Middle Aged
KIDNEY-TRANSPLANT
030304 developmental biology
Aged
Retrospective Studies
Hepatitis
Transplantation
MESH: Humans
Hepatology
business.industry
MESH : Humans
MESH: Hepatitis E
MESH : Follow-Up Studies
MESH: Adult
MESH: Polymerase Chain Reaction
MESH: Retrospective Studies
Organ Transplantation
medicine.disease
Fibrosis
Tacrolimus
United States
MESH: Male
Chronic infection
RECIPIENTS
[ SDV.SP ] Life Sciences [q-bio]/Pharmaceutical sciences
MESH : Hepatitis E
Immunology
REPLICATION
PEGYLATED INTERFERON-ALPHA
MESH: Europe
business
MESH: Female
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 00165085 and 15280012
- Database :
- OpenAIRE
- Journal :
- Gastroenterology, Gastroenterology, WB Saunders, 2011, 140 (5), pp.1481-9. ⟨10.1053/j.gastro.2011.02.050⟩, Gastroenterology, 140(5), 1481-1489. W B SAUNDERS CO-ELSEVIER INC, Gastroenterology, WB Saunders, 2011, 140 (5), pp.1481-9. 〈10.1053/j.gastro.2011.02.050〉, Gastroenterology, 2011, 140 (5), pp.1481-9. ⟨10.1053/j.gastro.2011.02.050⟩
- Accession number :
- edsair.doi.dedup.....f9c5a623ec45419d8c17e88de4e5e4e6