{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:14:18Z","timestamp":1793060058422,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,6,14]],"date-time":"2018-06-14T00:00:00Z","timestamp":1528934400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>An association between hepatitis E virus (<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>) infection and cryoglobulinemia has been suggested. The aims of this study were to assess the prevalence of cryoglobulinemia during<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>infection in solid\u2010organ\u2013transplant (<jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content>) recipients, to describe its outcomes under ribavirin therapy and to evaluate its effects on kidney function and histology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between November 2005 and June 2016, 128 cases of<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>infection were diagnosed among<jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content>recipients followed in our institution. Cryoglobulinemia data obtained from 66 patients during acute\u2010phase<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>and 51 patients during chronic\u2010phase<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>were compared to a historical control group of 89<jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content>recipients without<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>markers. Cryoglobulins were also monitored in a group of 43 patients treated by ribavirin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of cryoglobulinemia was increased in<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>\u2010infected<jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content>patients during a chronic phase (52.9%) compared to<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>\u2010infected<jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content>patients at acute phase (36.4%) (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.1) and to<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>\u2010negative<jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content>patients (23.6%) (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>.001).<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>infection was identified as an independent predictive factor for cryoglobulinemia (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>2.3, CI 95%: 1.17\u20104.55,<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.02). After ribavirin therapy and<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>clearance, the prevalence of cryoglobulin was significantly decreased from 53.5% to 20.9% (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.003). Kidney function was significantly worse and proteinuria tended to be higher in chronically<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>\u2010infected patients with cryoglobulinemia compared to those without cryoglobulinemia. Membranoproliferative glomerulonephritis was diagnosed in 2 patients, of which 1 had detectable cryoglobulinemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In conclusion, a relationship between<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>and cryoglobulin formation seems to exist. However, the clinical impact of cryoglobulinemia in<jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content>patients infected with<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>has to be confirmed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13894","type":"journal-article","created":{"date-parts":[[2018,5,30]],"date-time":"2018-05-30T07:15:02Z","timestamp":1527664502000},"page":"2178-2189","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Hepatitis E virus\u2013associated cryoglobulinemia in solid\u2010organ\u2013transplant recipients"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9702-1833","authenticated-orcid":false,"given":"Olivier","family":"Marion","sequence":"first","affiliation":[{"name":"Department of Nephrology and Organ Transplantation CHU Rangueil Toulouse France"},{"name":"Centre de Physiopathologie de Toulouse Purpan Inserm UMR1043 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