Hepatitis E virus (HEV) infection impacts a critical segment of solid organ transplant recipients, with new data revealing a significant risk of chronic hepatitis and extrahepatic complications.
A retrospective analysis of over 6,400 transplant patients found that 3.53% were diagnosed with HEV infection. Liver transplant recipients showed a higher incidence compared to other transplant groups.
Among infected patients, 65.1% developed chronic hepatitis within three months, indicating that while uncommon, HEV infection frequently progresses to a chronic state.
The use of tacrolimus was linked to higher rates of chronic hepatitis, while mycophenolic acid was associated with a lower likelihood of chronicity.
Ribavirin therapy proved highly effective, achieving a sustained virological response in 91.5% of patients when continued until viral clearance. However, a small subset experienced treatment resistance or progressed to cirrhosis.
HEV infection was also associated with extrahepatic complications, including neurological issues in 2.2% and glomerular disease in 3.9%, which often resolved after viral clearance.
These findings underscore the importance of HEV screening in transplant recipients with elevated liver enzymes and careful consideration of antiviral and immunosuppressive regimens.