{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:59:40Z","timestamp":1790395180921,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,7,14]],"date-time":"2015-07-14T00:00:00Z","timestamp":1436832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The chronic course of hepatitis E virus (<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>) infections in orthotopic liver transplant (<jats:styled-content style=\"fixed-case\">OLT<\/jats:styled-content>) recipients has been described previously, but prospectively collected data are rare. We aimed to study the role of chronic hepatitis E in <jats:styled-content style=\"fixed-case\">OLT<\/jats:styled-content> in a real\u2010life setting. Therefore, 287 adult <jats:styled-content style=\"fixed-case\">OLT<\/jats:styled-content> recipients (169 male [59%], median age 56\u00a0years) were prospectively tested by <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content> polymerase chain reaction assay (lower level of detection\u00a0=\u00a010\u00a0IU\/mL), irrespective of their level of liver enzymes. In 4 patients (1.4%), chronic <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content> infection was diagnosed. All 4 patients were male, and their age (median 48.5\u00a0years), the time since transplantation (median 45.5\u00a0months), and bilirubin level (median 0.6\u00a0mg\/dL) did not differ significantly from the total cohort. However, alanine transaminase and aspartame transaminase levels were significantly higher in <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>\u2010infected patients (75\u2013646\u00a0U\/L, median 216\u00a0U\/L and 68\u2013317\u00a0U\/L, median 108\u00a0U\/L) than in non\u2010infected patients (6\u2013617\u00a0U\/L, median 41 and 6\u2013355\u00a0U\/L, median 36; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.004 and 0.040, Mann\u2013Whitney test). In 3 patients, liver biopsy was performed and revealed signs of inflammation and chronic liver disease, as enlarged densely infiltrated portal tracts with mild\u2010to\u2010moderate interface hepatitis. All infected patients were treated with ribavirin with the starting dose adjusted to renal function (400\u2013800\u00a0mg\/day). In 2 patients, dose reduction was necessary. Transaminases normalized in all 4 patients, and all patients cleared their infection within 3\u00a0months of ribavirin treatment. However, 1 patient experienced viral relapse 12\u00a0weeks after discontinuation. Ribavirin medication was re\u2010started and viral clearance occurred within 8\u00a0weeks and persisted. Sequence analysis of the <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content> genome of this patient revealed that he was infected with an <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content> variant, which recently has been shown to have a reduced response to ribavirin in cell culture. The risk of chronic <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content> infections in <jats:styled-content style=\"fixed-case\">OLT<\/jats:styled-content> recipients in low\u2010endemic countries should not be overestimated. No case of chronic hepatitis E was observed in patients with normal liver enzymes, indicating that general screening of all <jats:styled-content style=\"fixed-case\">OLT<\/jats:styled-content> recipients is not necessary. However, if chronic hepatitis E develops, it can be treated efficiently with ribavirin.<\/jats:p>","DOI":"10.1111\/tid.12411","type":"journal-article","created":{"date-parts":[[2015,6,20]],"date-time":"2015-06-20T00:27:44Z","timestamp":1434760064000},"page":"617-622","source":"Crossref","is-referenced-by-count":31,"title":["Relevance of chronic hepatitis E in liver transplant recipients: a real\u2010life setting"],"prefix":"10.1111","volume":"17","author":[{"given":"A.","family":"Galante","sequence":"first","affiliation":[{"name":"Department of Medicine I University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Pischke","sequence":"additional","affiliation":[{"name":"Department of Medicine I University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Outpatient Clinic for Liver Transplantation University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Polywka","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Virology and Hygiene University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Luetgehethmann","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Virology and Hygiene University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.V.","family":"Suneetha","sequence":"additional","affiliation":[{"name":"Gastroenterology, Hepatology and Endocrinology Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Gisa","sequence":"additional","affiliation":[{"name":"Gastroenterology, Hepatology and Endocrinology Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Hiller","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.P.","family":"Dienes","sequence":"additional","affiliation":[{"name":"Clinical Institute of Pathology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Nashan","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Transplant Surgery University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.W.","family":"Lohse","sequence":"additional","affiliation":[{"name":"Department of Medicine I University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Sterneck","sequence":"additional","affiliation":[{"name":"Department of Medicine I University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Outpatient Clinic for Liver Transplantation University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,14]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706992"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.02.014"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21958"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2012.04200.x"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12183"},{"key":"e_1_2_5_7_1","first-page":"577","article-title":"Hepatitis E in Germany \u2013 an 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