Hepatitis E virus and renal transplantation.

摘要: Sepehrvand et al. demonstrated a considerable seroprevalence rate of anti-HEV in Iranian kidney transplant recipients [1]. The impact HEV infection on renal transplantation and the risk chronic this group are debated-issues that I would like to discuss. Hepatitis E virus (HEV) was first discovered New Delhi, India, 1955 [2]. is transmitted via oral-fecal route [3]. Other possible routes transmission include blood transfusions, drug vertical transmission, person-to-person contact, zoonotic [4][5]. frequency by non-fecal-oral remains unknown [2][6]. In endemic areas, exposure occurs childhood [7][8]. high-income countries, most cases hepatitis appear be acquired locally not imported from regions. these it likely has origin [9]. immunocompetent individuals, self-limited disease. However, can cause solid organ transplants [10][11], patients who receive chemotherapy [12], HIV-infected persons [13]. causes more than 60% transplants. Factors increase shorter interval since transplant, lower levels liver enzymes serum creatinine, platelet counts, tacrolimus-based immunosuppression (compared with cyclosporin A), significant which tacrolimus use low count [11][14][15]. In otherwise healthy recipients, might considered etiological agent for development those live regions [16]. Viral may progress rapidly cirrhosis [17]. Although occult transferred recipient graft [18], other allograft organs clear virus. As result, screening at time only recommended donors areas [19]. Such screen failure waiting transplantation. Rising enzyme nonspecific finding following Renal experience such increases, due primarily reactions, sepsis, hepatotropic virus-related infectious diseases. diagnosis viral usually made ELISA. IgG 6% 16% [10]. immunocompromised hosts, as hematological malignancies, avoid forming an infection. Moreover, viremia exist 6 months after acute [20]. addition, does universal. presentation associated normal negative serological assay [21]. This phenomenon underscores need molecular studies suspected subjects. Decreasing numbers doses immunosuppressive drugs approach toward controlling recipients. A prolonged follow-up period required assess eventual outcome [14]. pegylated interferon alpha-2b useful management infections whom reduction regimen insufficient [22]. Interestingly, 3-month Peg- IFN-α-2a therapy shown efficacious hemodialysis patient [23]. 2010, efficacy ribavirin 12 mg/kg body weight daily weeks reported short term (3 months), eradication could claimed [24]. 2011, another report course oral (17 mg/kg/day) induced sustained virological response 4 cessation [25]. long always evaluate patients. individuals. close diagnosis. result nonhepatic complications Neurological diseases affect peripheral or central nervous system have been Surprisingly, isolated cerebrospinal fluid [26].