Prevalence, morbidity, and therapy of hepatitis E virus infection in pediatric renal allograft recipients

Prevalence, morbidity, and therapy of hepatitis E virus infection in pediatric renal allograft... Background Hepatitis E virus (HEV) infection in immunocompromised patients such as solid organ transplant recipients may bear a high risk of becoming a chronic infection with progression to liver cirrhosis. So far, data on HEVinfection in pediatric renal transplant recipients are limited. Methods This single-center cohort study investigated period prevalence, morbidity, and treatment of HEV infection in 90 pediatric renal allograft recipients aged 9.9 ± 5.6 years at transplantation (58.9% males). HEV serology was determined by enzyme-linked immunosorbent assay and immunoblot, HEV replication by quantitative nucleic acid testing. Results Twelve of 90 (13.3%) patients were HEV seropositive, and 4/90 (4.4%) recipients showed active HEV replication (10 – 8 3 8 10 copies/mL, corresponding to 0.5 × 10 and 0.5 × 10 WHO IU/mL) in serum and stool. In all patients with HEV replication, genotype 3 was identified by partial sequencing of HEV ORF1 and ORF2 and phylogenetic analysis. All patients with HEV replication developed chronic infection associated with moderately elevated liver enzymes. HEV replication was unresponsive to reduction of immunosuppression, whereas ribavirin monotherapy (mean dosage 9.7 ± 3.6 mg/kg per day over 85 ± 11 days) was associated with sustained viral clearance and normalization of liver enzymes in all http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Pediatric Nephrology Springer Journals

Prevalence, morbidity, and therapy of hepatitis E virus infection in pediatric renal allograft recipients

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Publisher
Springer Journals
Copyright
Copyright © 2018 by IPNA
Subject
Medicine & Public Health; Pediatrics; Nephrology; Urology
ISSN
0931-041X
eISSN
1432-198X
D.O.I.
10.1007/s00467-018-3905-7
Publisher site
See Article on Publisher Site

Abstract

Background Hepatitis E virus (HEV) infection in immunocompromised patients such as solid organ transplant recipients may bear a high risk of becoming a chronic infection with progression to liver cirrhosis. So far, data on HEVinfection in pediatric renal transplant recipients are limited. Methods This single-center cohort study investigated period prevalence, morbidity, and treatment of HEV infection in 90 pediatric renal allograft recipients aged 9.9 ± 5.6 years at transplantation (58.9% males). HEV serology was determined by enzyme-linked immunosorbent assay and immunoblot, HEV replication by quantitative nucleic acid testing. Results Twelve of 90 (13.3%) patients were HEV seropositive, and 4/90 (4.4%) recipients showed active HEV replication (10 – 8 3 8 10 copies/mL, corresponding to 0.5 × 10 and 0.5 × 10 WHO IU/mL) in serum and stool. In all patients with HEV replication, genotype 3 was identified by partial sequencing of HEV ORF1 and ORF2 and phylogenetic analysis. All patients with HEV replication developed chronic infection associated with moderately elevated liver enzymes. HEV replication was unresponsive to reduction of immunosuppression, whereas ribavirin monotherapy (mean dosage 9.7 ± 3.6 mg/kg per day over 85 ± 11 days) was associated with sustained viral clearance and normalization of liver enzymes in all

Journal

Pediatric NephrologySpringer Journals

Published: Mar 2, 2018

References

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