Hepatitis E Virus Infection in Iranian Kidney-Transplant Patients

Hepatitis E virus infection is an endemic disease in developing and industrialized countries (1),and is responsible for acute and chronic hepatitis. Genotype 1 is more prevalent in developing countries, whereas genotype 3 is more common in developed countries (1). Chronic genotype 3 HEV infection can occur in solid-organ transplant patients (2), hematological patients who receive chemotherapy (3), and HIV-positive patients (4). In the past several years, HEV infection in organ transplant patients has garnered much interest. After kidney transplantation, HEV-related liver fibrosis can lead rapidly to cirrhosis (5). The use of tacrolimus, rather than cyclosporine A, and a low platelet count at HEV diagnosis have been identified as predictive factors for chronic HEV infection (6). However, decreased immunosuppressant dose can result in HEV clearance in nearly one-third of patients (6). In addition, ribavirin monotherapy can be efficacious in treating chronic HEV infection (7).