TY - JOUR
T1 - HEV infection in stem cell transplant recipients-retrospective study of EBMT Infectious Diseases Working Party
AU - Mikulska, Malgorzata
AU - Penack, Olaf
AU - Wendel, Lotus
AU - Knelange, Nina
AU - Cornelissen, Jan J
AU - Blijlevens, Nicole
AU - Passweg, Jakob
AU - Kroger, Nicolaus
AU - Bruns, Anke
AU - Koenecke, Christian
AU - Bierings, Marc
AU - Piñana, José Luis
AU - Labussiere-Wallet, Helene
AU - Ghesquieres, Herve
AU - Diaz, Miguel Angel
AU - Sampol, Antonia
AU - Averbuch, Diana
AU - de la Camara, Rafael
AU - Styczynski, Jan
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2022/2
Y1 - 2022/2
N2 - HEV infection is an emerging cause of acute and chronic hepatitis in stem cell transplant (SCT) recipients. We performed a retrospective observational study among EBMT centers with the aim of describing characteristics, management and outcome of HEV after SCT. There were 34 cases of HEV infection from 12 centers in 6 countries, diagnosed in median 4.5 months after SCT; 20 of acute and 14 of chronic infection. Non-hepatic findings possibly associated with HEV infection were present in 9 (26%). Patients with chronic infection had more characteristics associated with severely immunocompromised status. Ribavirin was provided to 16 patients (47%; 40% with acute and 57% with chronic infection), in median for 75 days. Three (19%) patients discontinued it due to side effects. HEV-RNA clearance occurred in 29 patients (85%; 85% in acute and 86% in chronic infection). HEV was considered a cause of death in 3 (9%), with 2 cases with late diagnosis. Reduction of immunosuppression in those receiving it, and ribavirin treatment in those with chronic infection were associated with shorter time to HEV-RNA clearance. Policy on HEV testing varied between the centers. In conclusion, acute and chronic HEV hepatitis should be promptly diagnosed and managed in SCT recipients.
AB - HEV infection is an emerging cause of acute and chronic hepatitis in stem cell transplant (SCT) recipients. We performed a retrospective observational study among EBMT centers with the aim of describing characteristics, management and outcome of HEV after SCT. There were 34 cases of HEV infection from 12 centers in 6 countries, diagnosed in median 4.5 months after SCT; 20 of acute and 14 of chronic infection. Non-hepatic findings possibly associated with HEV infection were present in 9 (26%). Patients with chronic infection had more characteristics associated with severely immunocompromised status. Ribavirin was provided to 16 patients (47%; 40% with acute and 57% with chronic infection), in median for 75 days. Three (19%) patients discontinued it due to side effects. HEV-RNA clearance occurred in 29 patients (85%; 85% in acute and 86% in chronic infection). HEV was considered a cause of death in 3 (9%), with 2 cases with late diagnosis. Reduction of immunosuppression in those receiving it, and ribavirin treatment in those with chronic infection were associated with shorter time to HEV-RNA clearance. Policy on HEV testing varied between the centers. In conclusion, acute and chronic HEV hepatitis should be promptly diagnosed and managed in SCT recipients.
KW - Communicable Diseases
KW - Hepatitis E virus/genetics
KW - Humans
KW - Immunocompromised Host
KW - RNA
KW - Retrospective Studies
KW - Ribavirin/therapeutic use
KW - Stem Cell Transplantation/adverse effects
KW - Transplant Recipients
UR - http://www.scopus.com/inward/record.url?scp=85117839322&partnerID=8YFLogxK
U2 - 10.1038/s41409-021-01497-2
DO - 10.1038/s41409-021-01497-2
M3 - Article
C2 - 34689177
SN - 0268-3369
VL - 57
SP - 167
EP - 175
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 2
ER -