Hepatitis E virus genotype 3 and capsid protein in the blood and urine of immunocompromised patients - 05/03/19
Highlights |
• | Urinary HEV Ag is a sensitive indicator of HEV infection in immunocompromised patients (96%). |
• | Acute phase serum HEV Ag concentration predicts the development of a chronic infection. |
• | Half of HEV-infected immunocompromised patients excrete infectious lipid-associated virions in the urine at the acute phase of HEV infection. |
• | The urinary HEV RNA/Ag detected is not associated with impaired kidney function or de novo proteinuria. |
Summary |
Objectives |
Hepatitis E virus genotype 3 (HEV3) is responsible for acute and chronic liver disease in solid organ transplant (SOT) recipients. HEV was recently found in the urine of some acutely and chronically genotype 4-infected patients.
Methods |
We examined the urinary excretion of HEV3 by 24 consecutive SOT recipients at the acute phase of HEV hepatitis and characterized the excreted virus.
Results |
Urinary HEV RNA was detected in 12 (50%) of the 24 transplanted patients diagnosed with HEV hepatitis. Urinary HEV antigen (Ag) was detected in all but one of the patients (96%). The density of RNA-containing HEV particles in urine was low (1.11-1.12 g/cm3), corresponding to lipid-associated virions. The urinary HEV RNA/Ag detected was not associated with impaired kidney function or de novo proteinuria. Finally, there was more HEV Ag in the serum at the acute phase of HEV infection in SOT recipients whose infection became chronic.
Conclusions |
HEV3 excreted via the urine of SOT recipients at the acute phase of HEV hepatitis has a lipid envelope. Renal function was not impaired. While urinary HEV Ag was a sensitive indicator of HEV infection, only acute phase serum HEV Ag indicated the development of a chronic infection.
Le texte complet de cet article est disponible en PDF.Keywords : Hepatitis E virus, HEV ORF2 capsid protein, Transplantation, Urine
Abbreviations : Ag, ALT, AP, AST, AUC, CI, eGFR, GGT, HEV, IQR, ORF, ROC, RT-PCR, S/CO, SOT
Plan
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Vol 78 - N° 3
P. 232-240 - mars 2019 Retour au numéro
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