Hepatitis E infection in solid organ transplant recipents

Turkey is located between HEV endemic and non-endemic regions with a HEV-IgG prevalence of 3 to 34%. After recognition of chronic HEV infection, increasing number of studies are published regarding HEV infection in solid organ transplant recipients. However, there are no data regarding HEV infection in transplant recipients in Turkey. The aim of this study was to investigate the prevalence of HEV infection in liver and kidney transplant recipients in Turkey. Material-Method: Seven transplantation centers from five different regions of Turkey participated and 492 serum/plasma samples from solid organ transplant recipients were collected. Sera were tested for HEV IgM, IgG (recomWell HEV IgG and IgM, Mikrogen Diagnostik, Germany) and HEV RNA (RealStar HEV RT-PCR, Altona Diagnostics, Germany) at the Dokuz Eylul University Hospital. Results: The study group had 185 liver and 300 renal tx recipients (64.7% male, 35.3% female) with the mean age of 42.9+/-16.5. Of the 485 patients 3 (0,6%) were HEV-IgM and 84 (17.3%) were HEV-IgG positive, while none was HEV-RNA positive. HEV-IgG was positive in 22% of the male, 8.8% of the female patients (p< 0,001). HEV-IgG prevalence was highest in samples coming from middle-east and south-east Turkey with a rate up to 42.9%. Other factors associated with higher IgG prevalence were older age and liver transplantation (p<0,001). Conclusion: The prevalence of HEV-IgM was 0.6% while HEV-IgG was 17.3% and associated with male gender, liver tx and older age in this multicenter study of solid organ transplant recipients in Turkey. None of the patients was HEV-RNA positive