PURPOSE OF REVIEW: Recipients of allogeneic stem cell transplantations are at risk of acquiring acute hepatitis E virus (HEV) infection, leading to chronicity. We review the incidence, sequela, extrahepatic manifestations, and treatment of hepatitis due to HEV infection in allogeneic hematopoietic stem cell transplantation (alloHSCT) recipients. RECENT FINDINGS: HEV infection and progression to chronic HEV in alloHSCT recipients are recently described. Misdiagnosis of HEV in alloHSCT recipients occurs, with liver enzyme abnormalities often attributed to hepatic graft-versus-host disease or drug-induced liver injury. HEV infection may occur in HSCT donors and emphasizes the need for HEV screening not only after HSCT, but also in donors presenting with liver function disturbances. The discussion about HEV screening of blood products will continue. Extrahepatic manifestations of hepatitis E are described. SUMMARY: HEV RNA screening in alloHSCT recipients with elevated liver enzymes is advised. Intervention strategies should be considered in cases of acute or chronic HEV infection. The first-line approach includes reduction of immunosuppressive medication. Oral ribavirin is in experienced hands a reasonable well tolerated treatment option, although the optimal dose, duration, and quantitative goals of ribavirin treatment are still unknown. Further studies are needed to improve our understanding of HEV, including extrahepatic manifestations and evaluation of therapeutic options.
PURPOSE OF REVIEW: Recipients of allogeneic stem cell transplantations are at risk of acquiring acute hepatitis E virus (HEV) infection, leading to chronicity. We review the incidence, sequela, extrahepatic manifestations, and treatment of hepatitis due to HEV infection in allogeneic hematopoietic stem cell transplantation (alloHSCT) recipients. RECENT FINDINGS:HEV infection and progression to chronic HEV in alloHSCT recipients are recently described. Misdiagnosis of HEV in alloHSCT recipients occurs, with liver enzyme abnormalities often attributed to hepatic graft-versus-host disease or drug-induced liver injury. HEV infection may occur in HSCT donors and emphasizes the need for HEV screening not only after HSCT, but also in donors presenting with liver function disturbances. The discussion about HEV screening of blood products will continue. Extrahepatic manifestations of hepatitis E are described. SUMMARY:HEV RNA screening in alloHSCT recipients with elevated liver enzymes is advised. Intervention strategies should be considered in cases of acute or chronic HEV infection. The first-line approach includes reduction of immunosuppressive medication. Oral ribavirin is in experienced hands a reasonable well tolerated treatment option, although the optimal dose, duration, and quantitative goals of ribavirin treatment are still unknown. Further studies are needed to improve our understanding of HEV, including extrahepatic manifestations and evaluation of therapeutic options.
Authors: Yijin Wang; Wenshi Wang; Lei Xu; Xinying Zhou; Ehsan Shokrollahi; Krzysztof Felczak; Luc J W van der Laan; Krzysztof W Pankiewicz; Dave Sprengers; Nicolaas J H Raat; Herold J Metselaar; Maikel P Peppelenbosch; Qiuwei Pan Journal: Antimicrob Agents Chemother Date: 2016-04-22 Impact factor: 5.191
Authors: Malgorzata Mikulska; Olaf Penack; Lotus Wendel; Nina Knelange; Jan J Cornelissen; Nicole Blijlevens; Jakob Passweg; Nicolaus Kroger; Anke Bruns; Christian Koenecke; Marc Bierings; José Luis Piñana; Helene Labussiere-Wallet; Herve Ghesquieres; Miguel Angel Diaz; Antonia Sampol; Diana Averbuch; Rafael de la Camara; Jan Styczynski Journal: Bone Marrow Transplant Date: 2021-10-23 Impact factor: 5.483
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