ArticleTransplantation direct2018
Prevalence and Clinical Correlates of Chronic Hepatitis E Infection in German Renal Transplant Recipients With Elevated Liver Enzymes.
Article in Transplantation direct, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Treatment for chronic hepatitis E virus infection: A systematic review and meta-analysis.Journal of viral hepatitis · 2021Pooled it
- Update on Hepatitis E Virus Infection 2025: Insights From an International Symposium.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Identification of novel rodent and shrew orthohepeviruses sheds light on hepatitis E virus evolution.Zoological research · 2025Article
- Hepatitis E virus: from innate sensing to adaptive immune responses.Nature reviews. Gastroenterology & hepatology · 2024Review
- Combining RNA Interference and RIG-I Activation to Inhibit Hepatitis E Virus Replication.Viruses · 2024Article
- Risk Factors for Hepatitis E Virus Infection and Eating Habits in Kidney Transplant Recipients.Pathogens (Basel, Switzerland) · 2023Article
- Evidence of a Link between Hepatitis E Virus Exposure and Glomerulonephritis Development.Viruses · 2023Article
- Molecular characterisation of a rabbit Hepatitis E Virus strain detected in a chronically HEV-infected individual from Germany.One health (Amsterdam, Netherlands) · 2023Article
- Article
- Article
- Case Report: Chronic hepatitis E virus Infection in an individual without evidence for immune deficiency.Frontiers in immunology · 2023Article
- Shear wave elastography-based liver fibrosis assessment in patients with chronic hepatitis E displays elevated liver stiffness regardless of previous antiviral therapy.Quantitative imaging in medicine and surgery · 2022Article
- Review
- An Unusual Cause of Hepatitis With Nephrotic Syndrome in a Kidney Transplant Recipient.Transplantation direct · 2022Article
- Prognostic Nomogram for Patients with Hepatitis E Virus-related Acute Liver Failure: A Multicenter Study in China.Journal of clinical and translational hepatology · 2021Article
- Monitoring of hepatitis E virus RNA during treatment for chronic hepatitis E virus infection after renal transplantation.Immunity, inflammation and disease · 2021Article
- Specific circulating microRNAs during hepatitis E infection can serve as indicator for chronic hepatitis E.Scientific reports · 2020Article
- Rituximab-Containing Treatment Regimens May Imply a Long-Term Risk for Difficult-To-Treat Chronic Hepatitis E.International journal of environmental research and public health · 2020Article
- Ribavirin as a First Treatment Approach for Hepatitis E Virus Infection in Transplant Recipient Patients.Microorganisms · 2019Article
- Adaptive Immune Responses in Hepatitis A Virus and Hepatitis E Virus Infections.Cold Spring Harbor perspectives in medicine · 2019Review
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElevated liver enzymes are frequently observed in renal transplant recipients and warrant further exploration. In immunosuppressed patients, hepatitis E virus (HEV) infection may cause chronic hepatitis, cirrhosis, and extrahepatic manifestations such as renal injury.
methodsWe performed a retrospective cross-sectional study investigating the prevalence, clinical correlates, and outcome of chronic HEV infection in a cohort of renal transplant recipients with elevated liver enzymes.
resultsOver a period of 30 months, 140 of 1469 renal transplant recipients had elevated liver enzymes, of which serum samples from 98 patients were available to determine HEV status. Seventeen patients were detected with HEV infection, of which 16 developed chronic HEV infection, while 1 patient controlled viremia (prevalence of chronic infection of 16.3%, with a minimum prevalence of 1.1% in the whole cohort). Increased liver stiffness was indicated by an average FibroScan result of 11.2 kPa in these patients. All 16 patients with chronic HEV infection were treated with ribavirin for a mean duration of 3 months. Five patients developed a viral rebound and received a second treatment course, of which 2 controlled HEV replication. Six months after the end of therapy, HEV clearance was achieved in 81.3% of the patients. One patient developed ribavirin resistance. Hemolytic anemia after ribavirin treatment was frequent, requiring blood transfusion in 3 patients. Four patients developed de novo glomerulonephritis, of which 2 were possibly associated with HEV infection.
conclusionsThis retrospective study showed that prevalence of chronic HEV infection was high in our renal transplant patient cohort and was associated with significant liver impairment and the occurrence of renal injury. Ribavirin treatment was effective and should be initiated early to avoid complications, but the risk of severe hemolytic anemia makes strict monitoring essential.
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Registered trials
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