Hepatitis E virus infection in the liver transplant recipients:Clinical presentation and management |
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Authors: | Avin Aggarwal Ryan B Perumpail Swetha Tummala Aijaz Ahmed |
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Institution: | Avin Aggarwal, Ryan B Perumpail, Swetha Tummala, Aijaz Ahmed, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA 94305, United States |
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Abstract: | Hepatitis E virus(HEV) is an emerging pathogen and an increasingly recognized cause of graft hepatitis, especially in the post-orthotopic liver transplantation immunocompromised population. The exact incidence and prevalence of HEV infection in this population remains unclear but is certainly greater than historical estimates. Identifying acute HEV infection in this population is imperative for choosing the right course of management as it is very difficult to distinguish histologically from acute rejection on liver biopsy. Current suggested approach to manage acute HEV involves modifying immunosuppression, especially discontinuing calcineurin inhibitors which are the preferred immunosuppressive agents post-orthotopic liver transplantation. The addition of ribavirin monotherapy has shown promising success rates in clearing HEV infection and is used commonly in reported cases. |
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Keywords: | Chronic hepatitis E infection Solid organ transplant Immunosuppression Ribavirin Hepatitis E virus Orthotopic liver transplantation |
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