Molecular detection of hepatitis E virus (HEV) in liver biopsies after liver transplantation

• Verfasst von: Protzer-Knolle, Ulrike [VerfasserIn]
• Verfasst von: Longerich, Thomas [VerfasserIn]
• Verfasst von: Navid, Mojdeh Heidary [VerfasserIn]
• Verfasst von: Schirmacher, Peter [VerfasserIn]
• Verfasst von: Schemmer, Peter [VerfasserIn]
• Verfasst von: Schnitzler, Paul [VerfasserIn]
• Verfasst von: Gotthardt, Daniel [VerfasserIn]
• Titel: Molecular detection of hepatitis E virus (HEV) in liver biopsies after liver transplantation
• Verf.angabe: Ulrike Protzer, Friederike Böhm, Thomas Longerich, Judith Seebach, Mojdeh Heidary Navid, Juliane Friemel, Ewerton Marques-Maggio, Marion Bawohl, Mathias Heikenwalder, Peter Schirmacher, Philipp Dutkowski, Pierre-Alain Clavien, Peter Schemmer, Paul Schnitzler, Daniel Gotthardt, Beat Müllhaupt and Achim Weber
• Umfang: 10 S.
• Fussnoten: published online 21 November 2014 ; Gesehen am 25.07.2017
• Titel Quelle: Enthalten in: Modern pathology
• Jahr Quelle: 2015
• Band/Heft Quelle: 28(2015), 4, S. 523-532
• ISSN Quelle: 1530-0285
• DOI: doi:10.1038/modpathol.2014.147
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1561195022

Abstract

We aimed to determine the rate of hepatitis E virus (HEV) infection, a recently increasingly recognized disease in the Western world, in liver transplant patients by direct molecular testing of liver tissue. A RT-PCR assay was designed for detecting the HEV open reading frame (ORF) 2/3 gene region in formalin-fixed, paraffin-embedded tissues, and applied to all liver biopsies (n=683) taken 4 weeks or later from all patients (n=282) after liver transplantation of two large academic centers. HEV-RNA was detected in ten biopsies from four different patients (rate: 1%). Histology in early HEV infection was variable including cases with only few hepatocellular apoptoses, no or only minute inflammation. Hepatitis lasted for at least 6 months in 3/4 patients. Serologic testing for HEV-RNA in a subcohort (159 patients) was positive in five patients (rate: 3%), resulting in an overall HEV detection rate of 3% (8/282). In case both liver tissue and sera of a patient were available fromthe same time period, all cases tested positive in one material were also tested positive in the other material, respectively. All patients had de novo autochthonous infection with HEV genotype 3. Our data confirm that HEV infection is a relevant cause of liver injury after liver transplantation. Molecular testing for HEV in routinely processed transplant liver biopsies is powerful for evaluating patients with elevated transaminases of unknown origin. Histology of HEV infection under immunosuppression in the early phase is distinct from HEV infection in immunocompetent individuals.