Reactivation of hepatitis E infection in a patient with acute lymphoblastic leukaemia after allogeneic stem cell transplantation
- P le Coutre1,
- H Meisel2,
- J Hofmann2,
- C Röcken3,
- G L Vuong1,
- S Neuburger1,
- P G Hemmati1,
- B Dörken1,
- R Arnold1
- 1Campus Virchow-Klinikum, Charité, Medizinische Klinik m.S. Hämatologie und Onkologie, Universitätsmedizin Berlin, Germany
- 2Institute of Medical Virology, Helmut-Ruska-Haus, Charité University Medicine, Berlin, Germany
- 3Institute of Pathology, Charité, University Hospital Berlin, Germany
- Dr P le Coutre, Campus Virchow-Klinikum, Charité, Medizinische Klinik m.S. Hämatologie und Onkologie, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; Philipp.lecoutre{at}charite.de
- Revised 12 December 2008
- Accepted 18 December 2008
Abstract
Hepatitis E virus (HEV) is the major cause of several outbreaks of waterborne hepatitis in tropical and subtropical countries and of sporadic cases of viral hepatitis in endemic and industrialised countries. Generally, HEV causes an acute self-limiting hepatitis. The clinical course is characterised by transient viraemia and transaminasaemia followed by a full hepatic recovery. Recent studies describe prolonged and chronic HEV infections in some immunosuppressed patients after solid organ transplantation. Here, an indigenous acute limited hepatitis E in a patient with Philadelphia chromosome-positive acute lymphoblastic leukaemia prior to allogeneic stem cell transplantation is reported. Fourteen weeks after stem cell transplantation, reappearance of HEV viraemia was observed, with increasing viral load and modestly elevated serum transaminases. Sequence analysis of the viral RNAs revealed a reactivation of endogenous HEV genotype 3, indicating viral persistence after recovery from acute hepatitis E.
Footnotes
-
Competing interests: None.
-
Patient consent: Obtained.
