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Hepatitis E Infections in Transplants

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Emerging Transplant Infections

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Abstract

The hepatitis E virus (HEV) is one of the main causative agents of acute viral hepatitis worldwide. Over the past decade, HEV genotypes 3 and 4 have been responsible for chronic infections in immunocompromised patients, especially solid organ transplant recipients. A rapid progression of liver fibrosis and the development of HEV-related cirrhosis have been documented in this specific population. HEV infections have also been associated with extrahepatic manifestations such as neurological disorders and kidney injuries. Despite a reduction in immunosuppressive regimens, approximately two-thirds of HEV-infected immunocompromised patients progress to chronic hepatitis and require antiviral therapy. Within the past years, ribavirin has been successfully used to treat chronic HEV infections. Current international guidelines recommend ribavirin monotherapy for a period of 12 weeks as the anti-HEV treatment of choice. The associated sustained virological response is approximately 80%. Nevertheless, a few cases of ribavirin failure have been documented. Further studies are needed to identify novel antiviral therapies for patients who are refractory to ribavirin.

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Abbreviations

HEV:

Hepatitis E virus

SVR:

Sustained virological response

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Authors and Affiliations

  1. Department of Nephrology, Dialysis and Organs Transplantation, CHU Rangueil, INSERM U1043, IFR –BMT, Paul Sabatier University, Toulouse, France

    Olivier Marion & Nassim Kamar

Authors
  1. Olivier Marion
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  2. Nassim Kamar
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Correspondence to Nassim Kamar .

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Editors and Affiliations

  1. Immunocompromised Host Service Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, USA

    Michele I. Morris

  2. Transplant and Immunocompromised Host Infectious Diseases, Infectious Diseases Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Camille Nelson Kotton

  3. Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, USA

    Cameron R. Wolfe

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  1. Infectious Diseases Division, Harvard University Medical School, Boston, MA, USA

    Camille Nelson Kotton

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Marion, O., Kamar, N. (2021). Hepatitis E Infections in Transplants. In: Morris, M.I., Kotton, C.N., Wolfe, C.R. (eds) Emerging Transplant Infections. Springer, Cham. https://doi.org/10.1007/978-3-030-25869-6_36

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  • DOI: https://doi.org/10.1007/978-3-030-25869-6_36

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  • Online ISBN: 978-3-030-25869-6

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