Characteristics of autochthonous hepatitis E virus infection in solid-organ transplant recipients in France

J Infect Dis. 2010 Sep 15;202(6):835-44. doi: 10.1086/655899.


Background: Hepatitis E virus (HEV) infections can lead to chronic hepatitis in immunocompromised patients. We have investigated the risk factors for HEV infection among solid-organ transplant recipients and the characteristics of these infections.

Methods: We performed serological tests, quantified the virus, and genotyped the virus in plasma samples. We performed a case-control study with HEV-infected patients and control participants matched for sex and age who were recruited from a population of solid-organ transplant recipients with no markers of HEV infection.

Results: We investigated 38 consecutive cases of HEV genotype 3 infection. Twenty-two (58%) of these 38 patients developed a chronic infection. The acute-phase aminotransferase levels were higher in the patients who cleared the virus than in those who developed chronic infections. The anti-HEV immunoglobulin G and immunoglobulin M profiles and HEV RNA concentration in patients who cleared the virus were similar to those in patients who developed a chronic infection. A logistic regression analysis of 37 case patients and 148 control participants indicated that the only factor independently associated with HEV infection was the consumption of game meat (68% of case patients vs 47% of control participants; odds ratio, 2.32; 95% confidence interval, 1.04-5.15).

Conclusion: Immunocompromised patients should avoid eating insufficiently cooked game meat or pork products so as to reduce the risk of HEV infection and chronic liver disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Animals
  • Birds / virology
  • Case-Control Studies
  • Chronic Disease
  • Feeding Behavior
  • Female
  • France / epidemiology
  • Genotype
  • Hepatitis Antibodies / blood
  • Hepatitis E / virology*
  • Hepatitis E virus / isolation & purification*
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Male
  • Meat / virology
  • Middle Aged
  • Molecular Sequence Data
  • RNA, Viral / blood
  • RNA, Viral / genetics
  • Risk Factors
  • Sequence Analysis, DNA
  • Swine / virology
  • Transplants / adverse effects*


  • Hepatitis Antibodies
  • Immunoglobulin G
  • Immunoglobulin M
  • RNA, Viral

Associated data

  • GENBANK/GU196319
  • GENBANK/GU196320
  • GENBANK/GU196321
  • GENBANK/GU196322
  • GENBANK/GU196323
  • GENBANK/GU196324
  • GENBANK/GU196325
  • GENBANK/GU196326
  • GENBANK/GU196327
  • GENBANK/GU196328
  • GENBANK/GU196329
  • GENBANK/GU196330