Hepatitis E virus genotype 3 infection in a tertiary referral center in the Netherlands: Clinical relevance and impact on patient morbidity
Section snippets
Background
Chronic HEV-3 infections are increasingly being reported in immunocompromised patients.
Objectives
To evaluate patients at risk and the effect of treatment strategies, we studied the clinical course, therapeutic interventions and treatment outcome in all patients diagnosed with HEV-3 viremia in our hospital.
Study design
This retrospective cohort-study was conducted at the Erasmus MC, University Medical Center Rotterdam, a tertiary referral and transplant center. We included all patients who tested positive for HEV RNA genotype 3 in serum or blood between January 2008 and March 2015.
Patients were tested prospectively for HEV RNA during yearly routine checkup after transplantation or in case of unexplained elevated liver enzymes.
Patients were included if they tested positive for HEV-3 RNA in serum or blood.
Results
A total of 80 patients tested positive for HEV RNA in serum. In all but one patient HEV-3 was detected so a total of 79 patients were included. Thirty-two patients (40.5%) were tested in the context of screening before or after transplantation, 5 (6.3%) were suspected of graft versus host disease (GvHD) and 42 (53.2%) were tested in case of unexplained hepatitis. Forty-nine patients were male (62.0%) and median age was 52 years (13–79). In total 61 patients (77.2%) were immunocompromised. Three
Discussion
We describe the clinical characteristics and outcome of HEV-3 infections in a tertiary referral hospital based population in the Netherlands and show that HEV can cause significant morbidity and contribute to mortality in patients. The off label use of ribavirin therapy provides viral clearance within a median of two months. To the best of our knowledge this retrospective single center study is the largest series so far to evaluate the clinical course and treatment outcome of HEV infection in
Conflicts of interest
None.
Funding
None.
Competing interests
None.
Ethical approval
Obtained from the Instutions Review Board of Erasmus MC, Rotterdam, the Netherlands.
Acknowledgements
None.
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