CHİEN-HUİ WU, CHENG-MAW HO, JİA-HUEİ TSAİ, HSİN-YUN SUN, REY-HENG HU, PO-HUANG LEE
Experimental and Clinical Transplantation - 2017;15(2):228-230
Chronic hepatitis in immunosuppressed patients because of infection with hepatitis E virus is increasingly recognized, but there is a paucity of knowledge about hepatitis E virus infection in solidorgan transplant recipients. Herein, we reported the first confirmatory case of hepatitis E virus genotype 4 infection in a 47-year-old woman who underwent a liver transplant recipient in Taiwan. The patient presented with unexplained hepatitis and severe jaundice. Hepatitis E virus RNA was present in serum and identified as the genotype 4 by reverse transcription polymerase chain reaction. Pathological findings revealed that prominent zone 3 canalicular and hepatocellular cholestasis with a few acidophilic bodies and giant cell transformation, which was typical of hepatitis E virus hepatitis. Even undergoing ribavirin treatment, she had worse cholestasis and recurrent urinary tract infections. She died from encephalopathy and sepsis 6 months after the initial presentation. So far, compared with genotype 3 hepatitis E virus hepatitis, genotype 4 hepatitis E virus infection in solidorgan transplant recipients has been reported less frequently in the literature, and that warrants further accumulation of experiences.
