{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:25:53Z","timestamp":1789053953073,"version":"build-2803163510"},"reference-count":41,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T00:00:00Z","timestamp":1743379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Hepatitis E virus (HEV) infection can become chronic in immunocompromised patients, like solid organ transplant recipients (SOTRs). We evaluated HEV prevalence, risk factors, and outcomes among SOTRs in a hyperendemic HEV area. Three hundred SOTRs were enrolled from April to July 2019 and tested for anti-HEV IgM and IgG and HEV RNA. Sixty-three recipients (21%) were positive for any HEV marker. HEV infection was independently associated with older age and pork liver sausage consumption. Three viremic recipients harbored genotype 3e and 3f according to HEV RNA sequencing and phylogenetic analysis. Overall, 10 recipients had markers of active\/recent infection (HEV RNA and\/or anti-HEV IgM) and were followed up prospectively. Five of them spontaneously resolved their HEV infection. In two recipients, HEV clearance was achieved only through immunosuppression reduction, while three needed ribavirin therapy to achieve virologic resolution. We observed a chronic course in 30% of SOTRs with active\/recent HEV infection. No association was found between tacrolimus assumption and chronicization. In conclusion, we found a high prevalence of infection among SOTRs attending a transplant center in a hyperendemic Italian HEV region. Systematic screening for all HEV markers and dietary education for infection control are needed for transplant recipients.<\/jats:p>","DOI":"10.3390\/v17040502","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T05:21:04Z","timestamp":1743398464000},"page":"502","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The Prevalence, Risk Factors, and Outcomes of Hepatitis E Virus Infection in Solid Organ Transplant Recipients in a Highly Endemic Area of Italy"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5875-4193","authenticated-orcid":false,"given":"Barbara","family":"Binda","sequence":"first","affiliation":[{"name":"General and Transplant Surgery Department, San Salvatore Hospital, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2036-9580","authenticated-orcid":false,"given":"Giovanna","family":"Picchi","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Life, Health and Environmental Sciences-MESVA, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"},{"name":"Infectious Diseases Department, ASL VT, PO Ospedale Belcolle Santa Rosa, 01100 Viterbo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3035-5510","authenticated-orcid":false,"given":"Roberto","family":"Bruni","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanita, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Di Gasbarro","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University \u201cG. D\u2019Annunzio\u201d Chieti-Pescara, 66100 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Madonna","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanita, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5236-041X","authenticated-orcid":false,"given":"Umbertina","family":"Villano","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanita, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Pisani","sequence":"additional","affiliation":[{"name":"National Center for the Control and Evaluation of Medicines, Istituto Superiore di Sanita, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Carocci","sequence":"additional","affiliation":[{"name":"National Center for the Control and Evaluation of Medicines, Istituto Superiore di Sanita, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Marcantonio","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanita, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8761-0052","authenticated-orcid":false,"given":"Filippo","family":"Montali","sequence":"additional","affiliation":[{"name":"General and Transplant Surgery Department, Dipartimento di Scienze Cliniche Applicate e Biotecnologiche-DISCAB, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3902-5315","authenticated-orcid":false,"given":"Alessandra","family":"Panarese","sequence":"additional","affiliation":[{"name":"General and Transplant Surgery Department, Dipartimento di Scienze Cliniche Applicate e Biotecnologiche-DISCAB, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Pisani","sequence":"additional","affiliation":[{"name":"General and Transplant Surgery Department, Dipartimento di Scienze Cliniche Applicate e Biotecnologiche-DISCAB, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Rita","family":"Ciccaglione","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanita, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enea","family":"Spada","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanita, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"001778","DOI":"10.1099\/jgv.0.001778","article-title":"ICTV Virus Taxonomy Profile: Hepeviridae 2022","volume":"103","author":"Purdy","year":"2022","journal-title":"J. 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