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                    <forename type="first">Lionel</forename>
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                <idno type="issn">0016-5085</idno>
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                <title level="j">Gastroenterology</title>
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                  <publisher>Elsevier</publisher>
                  <biblScope unit="volume">140</biblScope>
                  <biblScope unit="issue">5</biblScope>
                  <biblScope unit="pp">1481-9</biblScope>
                  <date type="datePub">2011-05</date>
                  <date type="dateEpub">2011-02-24</date>
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              <idno type="doi">10.1053/j.gastro.2011.02.050</idno>
              <idno type="pubmed">21354150</idno>
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            <textClass>
              <classCode scheme="mesh">Adult</classCode>
              <classCode scheme="mesh">Aged</classCode>
              <classCode scheme="mesh">Male</classCode>
              <classCode scheme="mesh">Middle Aged</classCode>
              <classCode scheme="mesh">Organ Transplantation</classCode>
              <classCode scheme="mesh">Polymerase Chain Reaction</classCode>
              <classCode scheme="mesh">RNA, Viral</classCode>
              <classCode scheme="mesh">Retrospective Studies</classCode>
              <classCode scheme="mesh">United States</classCode>
              <classCode scheme="mesh">Young Adult</classCode>
              <classCode scheme="mesh">Europe</classCode>
              <classCode scheme="mesh">Female</classCode>
              <classCode scheme="mesh">Follow-Up Studies</classCode>
              <classCode scheme="mesh">Hepatitis E</classCode>
              <classCode scheme="mesh">Hepatitis E virus</classCode>
              <classCode scheme="mesh">Hepatitis, Chronic</classCode>
              <classCode scheme="mesh">Humans</classCode>
              <classCode scheme="mesh">Incidence</classCode>
              <classCode scheme="halDomain" n="sdv.sp">Life Sciences [q-bio]/Pharmaceutical sciences</classCode>
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              <classCode scheme="halTreeTypology" n="ART">Journal articles</classCode>
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            <abstract xml:lang="en">
              <p>BACKGROUND &amp; AIMS: Hepatitis E virus (HEV) infection can cause chronic hepatitis in recipients of solid organ transplants. However, the factors that contribute to chronic infection and the outcomes of these patients are incompletely understood. We performed a retrospective analysis of data from 17 centers from Europe and the United States that described the progression, outcomes, and factors associated with development of chronic HEV infection in recipients of transplanted solid organs. METHODS: We studied data from 85 recipients of solid organ transplants who were infected with HEV. Chronic HEV infection was defined by the persistent increases in levels of liver enzymes and polymerase chain reaction evidence of HEV in the serum and/or stool for at least 6 months. RESULTS: Fifty-six patients (65.9%) developed chronic hepatitis. Univariate analysis associated liver transplant, shorter times since transplant, lower levels of liver enzymes and serum creatinine, lower platelet counts, and tacrolimus-based immunosuppressive therapy (rather than cyclosporin A) with chronic hepatitis. On multivariate analysis, the independent predictive factors associated with chronic HEV infection were the use of tacrolimus rather than cyclosporin A (odds ratio [OR], 1.87; 95% confidence interval [CI], 1.49-1.97; P = .004) and a low platelet count at the time of diagnosis with HEV infection (OR, 1.02; 95% CI, 1.001-1.1; P = .04). Of patients with chronic hepatitis, 18 (32.1%) achieved viral clearance after the dose of immunosuppressive therapy was reduced. No HEV reactivation was observed after HEV clearance. CONCLUSIONS: HEV infection causes chronic hepatitis in more than 60% of recipients of solid organ transplants. Tacrolimus therapy is the main predictive factor for chronic hepatitis. Dose reductions of immunosuppressive therapy resulted in viral clearance in more than 30% of patients.</p>
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              <addrLine>Drake Circus Plymouth Devon PL4 8AA United Kingdom</addrLine>
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        <org type="institution" xml:id="struct-1222305" status="VALID">
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          <idno type="Wikidata">Q7374067</idno>
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            <address>
              <addrLine>Treliske – Truro – TR1 3LJ – Great-Britain</addrLine>
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        <org type="institution" xml:id="struct-357843" status="INCOMING">
          <orgName>University Health Center</orgName>
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            <address>
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        <org type="institution" xml:id="struct-357844" status="INCOMING">
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        <org type="institution" xml:id="struct-300906" status="VALID">
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          <orgName>CHU Limoges</orgName>
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            <address>
              <addrLine>Centre Hospitalier Universitaire Dupuytren - 2 avenue Martin Luther King 87042 LIMOGES</addrLine>
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            <ref type="url">http://www.chu-limoges.fr/</ref>
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        <org type="institution" xml:id="struct-300924" status="VALID">
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              <addrLine>14 rue Paul Gaffarel - 21079 Dijon</addrLine>
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          <orgName>Hôpital de la Croix-Rousse [CHU - HCL]</orgName>
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              <addrLine>103 Grande Rue de la Croix-Rousse69004 Lyon</addrLine>
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          <orgName>Hôpital Paul Brousse</orgName>
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            <address>
              <addrLine>12 Avenue Paul Vaillant Couturier, 94800 Villejuif</addrLine>
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        <org type="regroupinstitution" xml:id="struct-1066727" status="VALID">
          <orgName>AP-HP. Université Paris Saclay</orgName>
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            <address>
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            <ref type="url">https://www.aphp.fr/groupes-hospitaliers-de-lap-hp</ref>
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</TEI>