A Nationwide Survey of Hepatitis E Virus Infection and Chronic Hepatitis E in Liver Transplant Recipients in Japan

Yuki Inagaki, Yukio Oshiro, Tomohiro Tanaka, Tomoharu Yoshizumi, Hideaki Okajima, Kohei Ishiyama, Chikashi Nakanishi, Masaaki Hidaka, Hiroshi Wada, Taizo Hibi, Kosei Takagi, Masaki Honda, Kaori Kuramitsu, Hideaki Tanaka, Taiji Tohyama, Toshihiko Ikegami, Satoru Imura, Tsuyoshi Shimamura, Yoshimi Nakayama, Taizen UrahashiKazumasa Yamagishi, Hiroshi Ohnishi, Shigeo Nagashima, Masaharu Takahashi, Ken Shirabe, Norihiro Kokudo, Hiroaki Okamoto, Nobuhiro Ohkohchi

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: Recently, chronic hepatitis E has been increasingly reported in organ transplant recipients in European countries. In Japan, the prevalence of hepatitis E virus (HEV) infection after transplantation remains unclear, so we conducted a nationwide cross-sectional study to clarify the prevalence of chronic HEV infection in Japanese liver transplant recipients. Methods: A total of 1893 liver transplant recipients in 17 university hospitals in Japan were examined for the presence of immunoglobulin G (IgG), IgM and IgA classes of anti-HEV antibodies, and HEV RNA in serum. Findings: The prevalence of anti-HEV IgG, IgM and IgA class antibodies was 2.9% (54/1893), 0.05% (1/1893) and 0% (0/1893), respectively. Of 1651 patients tested for HEV RNA, two patients (0.12%) were found to be positive and developed chronic infection after liver transplantation. In both cases, HEV RNA was also detected in one of the blood products transfused at the perioperative period. Analysis of the HEV genomes revealed that the HEV isolates obtained from the recipients and the transfused blood products were identical in both cases, indicating transfusion-transmitted HEV infection. Interpretation: The prevalence of HEV antibodies in liver transplant recipients was 2.9%, which is low compared with the healthy population in Japan and with organ transplant recipients in European countries; however, the present study found, for the first time, two Japanese patients with chronic HEV infection that was acquired via blood transfusion during or after liver transplantation.

Original languageEnglish
Pages (from-to)1607-1612
Number of pages6
JournalEBioMedicine
Volume2
Issue number11
DOIs
Publication statusPublished - 2015 Nov 1

Keywords

  • Chronic hepatitis E
  • Hepatitis E virus
  • Liver transplantation
  • Transfusion

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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    Inagaki, Y., Oshiro, Y., Tanaka, T., Yoshizumi, T., Okajima, H., Ishiyama, K., Nakanishi, C., Hidaka, M., Wada, H., Hibi, T., Takagi, K., Honda, M., Kuramitsu, K., Tanaka, H., Tohyama, T., Ikegami, T., Imura, S., Shimamura, T., Nakayama, Y., ... Ohkohchi, N. (2015). A Nationwide Survey of Hepatitis E Virus Infection and Chronic Hepatitis E in Liver Transplant Recipients in Japan. EBioMedicine, 2(11), 1607-1612. https://doi.org/10.1016/j.ebiom.2015.09.030