{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:12:39Z","timestamp":1793059959009,"version":"4.5.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin J Gastroenterol"],"published-print":{"date-parts":[[2025,10]]},"DOI":"10.1007\/s12328-025-02188-x","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T09:11:44Z","timestamp":1753953104000},"page":"953-961","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Delayed recurrence of hepatitis E virus RNA in serum and feces after ribavirin therapy for chronic hepatitis E: importance of extended follow-up"],"prefix":"10.1007","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3612-7364","authenticated-orcid":false,"given":"Hiroshi","family":"Okano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minoru","family":"Mizutani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiki","family":"Kawakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsumi","family":"Mukai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Nishimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaharu","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumoto","family":"Murata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Okamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"2188_CR1","doi-asserted-by":"publisher","first-page":"456","DOI":"10.3390\/v11050456","volume":"11","author":"PP Primadharsini","year":"2019","unstructured":"Primadharsini PP, Nagashima S, Okamoto H. Genetic variability and evolution of hepatitis E virus. Viruses. 2019;11:456.","journal-title":"Viruses"},{"key":"2188_CR2","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1056\/NEJMoa0706992","volume":"358","author":"N Kamar","year":"2008","unstructured":"Kamar N, Selves J, Mansuy JM, et al. Hepatitis E virus and chronic hepatitis in organ-transplant recipients. N Engl J Med. 2008;358:811\u20137.","journal-title":"N Engl J Med"},{"issue":"788","key":"2188_CR3","volume":"28","author":"CY Chiu","year":"2022","unstructured":"Chiu CY, Zhang HC, Westin J, et al. Hepatitis E virus infection in cancer patients. Transplant Cell Ther. 2022;28(788): e1-788 e5.","journal-title":"Transplant Cell Ther"},{"key":"2188_CR4","doi-asserted-by":"publisher","first-page":"2194","DOI":"10.4254\/wjh.v7.i19.2194","volume":"7","author":"AR Murali","year":"2015","unstructured":"Murali AR, Kotwal V, Chawla S. Chronic hepatitis E: a brief review. World J Hepatol. 2015;7:2194\u2013201.","journal-title":"World J Hepatol"},{"key":"2188_CR5","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1016\/j.ebiom.2015.09.030","volume":"2","author":"Y Inagaki","year":"2015","unstructured":"Inagaki Y, Oshiro Y, Tanaka T, et al. A Nationwide survey of hepatitis E virus infection and chronic hepatitis E in liver transplant recipients in Japan. EBioMedicine. 2015;2:1607\u201312.","journal-title":"EBioMedicine"},{"key":"2188_CR6","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1097\/TP.0000000000002801","volume":"104","author":"Y Owada","year":"2020","unstructured":"Owada Y, Oshiro Y, Inagaki Y, et al. A nationwide survey of hepatitis E virus infection and chronic hepatitis in heart and kidney transplant recipients in Japan. Transplant. 2020;104:437\u201344.","journal-title":"Transplant"},{"key":"2188_CR7","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1007\/s12328-019-01024-3","volume":"13","author":"H Okano","year":"2020","unstructured":"Okano H, Nakano T, Ito R, et al. The spontaneous clearance of hepatitis E virus (HEV) and emergence of HEV antibodies in a transfusion-transmitted chronic hepatitis E case after completion of chemotherapy for acute myeloid leukemia. Clin J Gastroenterol. 2020;13:252\u20139.","journal-title":"Clin J Gastroenterol"},{"key":"2188_CR8","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1056\/NEJMoa1215246","volume":"370","author":"N Kamar","year":"2014","unstructured":"Kamar N, Izopet J, Tripon S, et al. Ribavirin for chronic hepatitis E virus infection in transplant recipients. N Engl J Med. 2014;370:1111\u201320.","journal-title":"N Engl J Med"},{"key":"2188_CR9","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1016\/j.jhep.2018.03.005","volume":"68","author":"European Association for the Study of the Liver","year":"2018","unstructured":"European Association for the Study of the Liver. EASL Clinical Practice Guidelines on hepatitis E virus infection. J Hepatol. 2018;68:1256\u201371.","journal-title":"J Hepatol"},{"key":"2188_CR10","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1016\/j.jhep.2022.05.006","volume":"77","author":"Z Ma","year":"2022","unstructured":"Ma Z, de Man RA, Kamar N, et al. Chronic hepatitis E: Advancing research and patient care. J Hepatol. 2022;77:1109\u201323.","journal-title":"J Hepatol"},{"key":"2188_CR11","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1097\/TP.0000000000001908","volume":"102","author":"S McPherson","year":"2018","unstructured":"McPherson S, Elsharkawy AM, Ankcorn M, et al. Summary of the British transplantation society UK guidelines for hepatitis E and solid organ transplantation. Transplant. 2018;102:15\u201320.","journal-title":"Transplant"},{"key":"2188_CR12","doi-asserted-by":"publisher","first-page":"3209","DOI":"10.1128\/JCM.40.9.3209-3218.2002","volume":"40","author":"H Mizuo","year":"2002","unstructured":"Mizuo H, Suzuki K, Takikawa Y, et al. Polyphyletic strains of hepatitis E virus are responsible for sporadic cases of acute hepatitis in Japan. J Clin Microbiol. 2002;40:3209\u201318.","journal-title":"J Clin Microbiol"},{"key":"2188_CR13","doi-asserted-by":"publisher","first-page":"3022","DOI":"10.1093\/molbev\/msab120","volume":"38","author":"K Tamura","year":"2021","unstructured":"Tamura K, Stecher G, Kumar S. MEGA11: molecular evolutionary genetics analysis version 11. Mol Biol Evol. 2021;38:3022\u20137.","journal-title":"Mol Biol Evol"},{"key":"2188_CR14","first-page":"E63","volume":"44","author":"H Okano","year":"2014","unstructured":"Okano H, Takahashi M, Isono Y, et al. Characterization of sporadic acute hepatitis E and comparison of hepatitis E virus genomes in acute hepatitis patients and pig liver sold as food in Mie. Japan Hepatol Res. 2014;44:E63\u201376.","journal-title":"Japan Hepatol Res"},{"key":"2188_CR15","doi-asserted-by":"publisher","first-page":"3671","DOI":"10.1128\/JCM.01086-07","volume":"45","author":"M Takahashi","year":"2007","unstructured":"Takahashi M, Tanaka T, Azuma M, et al. Prolonged fecal shedding of hepatitis E virus (HEV) during sporadic acute hepatitis E: evaluation of infectivity of HEV in fecal specimens in a cell culture system. J Clin Microbiol. 2007;45:3671\u20139.","journal-title":"J Clin Microbiol"},{"key":"2188_CR16","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1016\/j.ad.2012.11.017","volume":"105","author":"L Puig","year":"2014","unstructured":"Puig L. Methotrexate: new therapeutic approaches. Actas Dermosifiliogr. 2014;105:583\u20139.","journal-title":"Actas Dermosifiliogr"},{"key":"2188_CR17","doi-asserted-by":"publisher","first-page":"9199","DOI":"10.1038\/s41598-021-88491-2","volume":"11","author":"P Nived","year":"2021","unstructured":"Nived P, Pettersson \u00c5, J\u00f6nsson G, et al. Methotrexate reduces circulating Th17 cells and impairs plasmablast and memory B cell expansions following pneumococcal conjugate immunization in RA patients. Sci Rep. 2021;11:9199.","journal-title":"Sci Rep"},{"key":"2188_CR18","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1046\/j.1365-2249.1999.00753.x","volume":"115","author":"MF Neurath","year":"1999","unstructured":"Neurath MF, Hildner K, Becker C, et al. Methotrexate specifically modulates cytokine production by T cells and macrophages in murine collagen-induced arthritis (CIA): a mechanism for methotrexate-mediated immunosuppression. Clin Exp Immunol. 1999;115:42\u201355.","journal-title":"Clin Exp Immunol"},{"key":"2188_CR19","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1111\/ajd.13546","volume":"62","author":"A Azzam","year":"2021","unstructured":"Azzam A, Jiyad Z, O\u2019Beirne J. Is methotrexate hepatotoxicity associated with cumulative dose? A systematic review and meta-analysis. Australas J Dermatol. 2021;62:130\u201340.","journal-title":"Australas J Dermatol"},{"key":"2188_CR20","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/j.jceh.2013.08.013","volume":"3","author":"A Kumar","year":"2013","unstructured":"Kumar A, Saraswat VA. Hepatitis E and acute-on-chronic liver failure. J Clin Exp Hepatol. 2013;3:225\u201330.","journal-title":"J Clin Exp Hepatol"},{"key":"2188_CR21","doi-asserted-by":"publisher","first-page":"6341","DOI":"10.12998\/wjcc.v10.i19.6341","volume":"10","author":"C Chen","year":"2022","unstructured":"Chen C, Zhang SY, Chen L. Review of clinical characteristics, immune responses and regulatory mechanisms of hepatitis E-associated liver failure. World J Clin Cases. 2022;10:6341\u20138.","journal-title":"World J Clin Cases"},{"key":"2188_CR22","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1002\/ajh.20374","volume":"79","author":"M Masuda","year":"2005","unstructured":"Masuda M, Teramura M, Matsuda A, et al. Clonal T cells of pure red-cell aplasia. Am J Hematol. 2005;79:332\u20133.","journal-title":"Am J Hematol"},{"key":"2188_CR23","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.imlet.2012.12.006","volume":"150","author":"Y Michishita","year":"2013","unstructured":"Michishita Y, Hirokawa M, Fujishima N, et al. CDR3-independent expansion of V\u03b41 T lymphocytes in acquired chronic pure red cell aplasia. Immunol Lett. 2013;150:23\u20139.","journal-title":"Immunol Lett"},{"key":"2188_CR24","first-page":"893","volume":"63","author":"F Ishida","year":"2022","unstructured":"Ishida F. Clinical and pathophysiological features of acquired pure red cell aplasia: based on the concept of T-cell dysregulations. Rinsho Ketsueki. 2022;63:893\u20138.","journal-title":"Rinsho Ketsueki"},{"key":"2188_CR25","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1016\/j.amjms.2023.06.009","volume":"366","author":"RT Means Jr","year":"2023","unstructured":"Means RT Jr. Pure red cell aplasia: the second hundred years. Am J Med Sci. 2023;366:160\u20136.","journal-title":"Am J Med Sci"},{"key":"2188_CR26","doi-asserted-by":"publisher","first-page":"475","DOI":"10.2165\/00002018-199920060-00002","volume":"20","author":"L Georgescu","year":"1999","unstructured":"Georgescu L, Paget SA. Lymphoma in patients with rheumatoid arthritis: what is the evidence of a link with methotrexate? Drug Saf. 1999;20:475\u201387.","journal-title":"Drug Saf"},{"key":"2188_CR27","doi-asserted-by":"publisher","first-page":"2150","DOI":"10.1378\/chest.123.6.2150","volume":"123","author":"CT Ebeo","year":"2003","unstructured":"Ebeo CT, Girish MR, Byrd RP, et al. Methotrexate-induced pulmonary lymphoma. Chest. 2003;123:2150\u20133.","journal-title":"Chest"},{"key":"2188_CR28","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1186\/s12876-021-01849-8","volume":"21","author":"Y Osaki","year":"2021","unstructured":"Osaki Y, Kawaratani H, Kachi H, Matsuura K, Tsuji Y, Ozutsumi T, Takagi H, Furukawa M, Sawada Y, Mitoro A, Yamao J, Yoshiji H. Small intestinal follicular lymphoma induced by methotrexate: a case report. BMC Gastroenterol. 2021;21:280.","journal-title":"BMC Gastroenterol"},{"key":"2188_CR29","doi-asserted-by":"publisher","first-page":"430","DOI":"10.5414\/CP204372","volume":"61","author":"R Inose","year":"2023","unstructured":"Inose R, Nakamura A, Omi R, et al. Risks of malignant lymphoma in rheumatoid arthritis patients receiving methotrexate-alone and in combination therapy compared with the general population: a study based on a Japanese medical claims database. Int J Clin Pharmacol Ther. 2023;61:430\u20136.","journal-title":"Int J Clin Pharmacol Ther"}],"container-title":["Clinical Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12328-025-02188-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12328-025-02188-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12328-025-02188-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T15:21:17Z","timestamp":1758813677000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12328-025-02188-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,31]]},"references-count":29,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["2188"],"URL":"https:\/\/doi.org\/10.1007\/s12328-025-02188-x","relation":{},"ISSN":["1865-7257","1865-7265"],"issn-type":[{"value":"1865-7257","type":"print"},{"value":"1865-7265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,31]]},"assertion":[{"value":"6 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All the authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Informed consent was obtained from the patient to publish the clinical and virological findings.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"All the procedures were performed in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human rights"}}]}}