Risk factors associated with Hepatitis E virus infection in kidney transplant recipients in a single tertiary Center in the United States

Vorada Sakulsaengprapha; Paul Wasuwanich; Supharerk Thawillarp; Thammasin Ingviya; Premporn Phimphilai; Paul K Sue; Annette M Jackson; Edward S Kraus; Eyasu H Teshale; Saleem Kamili; Wikrom Karnsakul

doi:10.1016/j.trim.2023.101809

Risk factors associated with Hepatitis E virus infection in kidney transplant recipients in a single tertiary Center in the United States

Transpl Immunol. 2023 Jun:78:101809. doi: 10.1016/j.trim.2023.101809. Epub 2023 Mar 1.

Affiliations

¹ Johns Hopkins University School of Medicine, Baltimore, MD, USA.
² Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
³ Department of Environmental Health Sciences, Johns Hopkins University, Baltimore, MD, USA.
⁴ Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, CDC, Atlanta, GA, USA.
⁵ Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: wkarnsa1@jhmi.edu.

PMID: 36863665
DOI: 10.1016/j.trim.2023.101809

Abstract

Background: Hepatitis E virus (HEV), the causative agent of hepatitis E, is a common but self-limiting disease. However, in immunosuppressed kidney transplant 47 recipients (KTRs), HEV infection can become chronic. We investigated risk factors associated with HEV infection among 271 KTRs at the Johns Hopkins Hospital transplanted between 1988 and 2012.

Methods: HEV infection was defined as having positive anti-HEV IgM, anti-HEV IgG, or HEV RNA. The risk factors included: age at transplant, sex, hemodialysis/peritoneal dialysis, plasmapheresis, transfusions, community urbanization, and other socioeconomic factors. Logistic regression was used to determine independent risk factors associated with HEV infection.

Results: Out of 271 KTRs, 43 (16%) had HEV infection though not active disease. HEV infection in KTRs was associated with older age (≥45 years; OR = 4.04; 95% CI = 1.81-57 10.03; p = 0.001) and living in communities with low proportions of minorities (OR = 0.22; 95% 58 CI = 0.04-0.90; p = 0.046).

Conclusion: KTRs who had HEV infection may be at an increased risk of developing chronic HEV.

Keywords: Hepatitis E virus; Kidney transplantation; Risk factors; Seroepidemiologic studies.

MeSH terms

Hepatitis Antibodies
Hepatitis E virus* / genetics
Hepatitis E* / epidemiology
Hepatitis E* / etiology
Humans
Kidney Transplantation* / adverse effects
RNA, Viral
Risk Factors
Seroepidemiologic Studies
Transplant Recipients
United States / epidemiology

Substances

RNA, Viral
Hepatitis Antibodies