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Peer reviewedOpen accessHepatitis E

Rat Hepatitis E Virus as Cause of Persistent Hepatitis after Liver Transplant

Emerging Infectious Diseases·

Siddharth Sridhar, Cyril C.Y. Yip, Shusheng Wu, Jianpiao Cai, Anna Jin-Xia Zhang, Kit-Hang Leung, Tom W.H. Chung, Jasper F.W. Chan, Wan-Mui Chan, Jade L.L. Teng, Rex K.H. Au-Yeung, Vincent C.C. Cheng, Honglin Chen, Susanna K.P. Lau, Patrick C.Y. Woo, Ning-Shao Xia, Chung-Mau Lo, Kwok-Yung Yuen

DOI
10.3201/eid2412.180937
PMID
30457530
PMCID
PMC6256372
OpenAlex
W2899989846
Study type
Genomic study
Publisher
Centers for Disease Control and Prevention (CDC)
Article type
journal-article
Integrity
current

Why this research matters now

The report indicates that routine hepatitis E tests may fail to identify HEV-C infection and identifies possible relevance for evaluation of unexplained hepatitis. It also describes HEV-C as a potential concern for blood product safety, without providing population-level risk estimates.

01

Structured evidence summary

Research question

The report examined whether HEV-C, a divergent rat-associated hepatitis E virus, can infect humans and cause hepatitis after liver transplantation.

Study design

This was a peer-reviewed report of a single clinical infection with viral genomic characterization. HEV-C RNA and antigen were assessed in clinical and liver samples, and the isolate's complete genome was compared with another HEV-C strain.

Population and setting

The reported patient was a liver transplant recipient with hepatitis attributed to HEV-C infection. The abstract also discusses possible testing in immunocompromised and immunocompetent patients with unexplained hepatitis, but it does not provide a broader study population.

Main findings

HEV-C genetic material was identified in several clinical samples and viral antigen was detected in the liver. The patient had HEV antibodies before infection, but these did not prevent infection; ribavirin treatment was associated with resolution of hepatitis and clearance of detectable viremia.

Public-health relevance

The report indicates that routine hepatitis E tests may fail to identify HEV-C infection and identifies possible relevance for evaluation of unexplained hepatitis. It also describes HEV-C as a potential concern for blood product safety, without providing population-level risk estimates.

Important limitations

The evidence comes from a single reported liver transplant recipient and does not establish frequency, transmission patterns, population risk, or treatment effectiveness beyond this case. This summary is limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade interpretation.

GIDS interpretation

The article is discoverable under hepatitis E, diagnostics, genomic epidemiology, One Health, and treatment, with metadata linking it to Hong Kong, China, and Vietnam. It provides case-level clinical and genomic context only and does not confirm or characterize a live surveillance signal.

02

Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

03

Evidence relationships

This article has 12 auditable classifier relationships to diseases, places, topics, and study design.

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