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Hepatitis E and Allogeneic Hematopoietic Stem Cell Transplantation: A French Nationwide SFGM-TC Retrospective Study

1
Service d’hématologie-greffe, Hôpital Saint-Louis, Université Paris-Diderot, 75010 Paris, France
2
Service de virologie, Hôpital Paul-Brousse, 94804 Villejuif, France
3
INSERM 1193 et CNR hépatite A et E, Université Paris-Sud, 94804 Villejuif, France
4
Service d’hépatologie, Hôpital Cochin, Université Paris Descartes, INSERM U1223, Institut Pasteur, 75014 Paris, France
5
Service d’hématologie, Hôpital La Pitié-Salpêtrière, 75013 Paris, France
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Service d’hématologie, Centre Hospitalier Universitaire, 06000 Nice, France
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Service d’hématologie, CHU Bordeaux, 33600 Pessac, France
8
Service d’hématologie, Hôpital Percy, 92140 Clamart, France
9
Service d’hématologie, CHU, 37000 Tours, France
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Laboratoire de virologie et CNR hépatite E, CHU, 31000 Toulouse, France
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Service d’hématologie, CHU, 31000 Toulouse, France
*
Author to whom correspondence should be addressed.
Viruses 2019, 11(7), 622; https://doi.org/10.3390/v11070622
Received: 24 April 2019 / Revised: 2 July 2019 / Accepted: 4 July 2019 / Published: 5 July 2019
(This article belongs to the Special Issue Hepatitis E Virus)
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Abstract

Usually self-limited, hepatitis E virus (HEV) infection may evolve to chronicity and cirrhosis in immunosuppressed patients. HEV infection has been described in solid-organ transplantation and hematology patients, but for allogeneic hematopoietic stem cell transplant (alloHSCT) recipients, only small cohorts are available. This retrospective nationwide multi-center series aimed to describe HEV diagnostic practices in alloHSCT French centers, and the course of infection in the context of alloHSCT. Twenty-nine out of 37 centers participated. HEV search in case of liver function tests (LFT) abnormalities was never performed in 24% of centers, occasionally in 55%, and systematically in 21%. Twenty-five cases of active HEV infection were diagnosed in seven centers, all because of LFT abnormalities, by blood nucleic acid testing. HEV infection was diagnosed in three patients before alloHSCT; HEV infection did not influence transplantation planning, and resolved spontaneously before or after alloHSCT. Twenty-two patients were diagnosed a median of 283 days after alloHSCT. Nine patients (41%) had spontaneous viral clearance, mostly after immunosuppressive treatment decrease. Thirteen patients (59%) received ribavirin, with sustained viral clearance in 11/12 evaluable patients. We observed three HEV recurrences but no HEV-related death or liver failure, nor evolution to cirrhosis. View Full-Text
Keywords: allogeneic hematopoietic stem transplantation; hepatitis E allogeneic hematopoietic stem transplantation; hepatitis E
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Xhaard, A.; Roque-Afonso, A.-M.; Mallet, V.; Ribaud, P.; Nguyen-Quoc, S.; Rohrlich, P.-S.; Tabrizi, R.; Konopacki, J.; Lissandre, S.; Abravanel, F.; Latour, R.P.; Huynh, A. Hepatitis E and Allogeneic Hematopoietic Stem Cell Transplantation: A French Nationwide SFGM-TC Retrospective Study. Viruses 2019, 11, 622.

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