Hepatitis E virus (HEV), a causative agent of hepatitis E, is indigenous to Japan, and pigs and wild boars are established as primary reservoirs of HEV. As HEV is present in the circulating blood of infected hosts, blood-borne HEV transmission is possible. Patients with hematological disorders are at considerable risk of transmission from blood-borne sources. Although HEV viremia is typically transient, cases of chronic HEV infection are increasingly reported in immunocompromised patients, including solid-organ transplant recipients and patients with hematological disorders. In Japan, although nationwide studies have reported the presence of chronic HEV infection in solid-organ transplant recipients, no such study has been conducted on patients with hematological disorders, including those after hematopoietic stem cell transplantation (HSCT). To date, at least 13 cases with hematological disorders acquiring HEV infection have been reported in Japan, mostly through blood transfusion, including those with chronic hepatitis E and fatal fulminant hepatitis E. Thus, clinicians should be aware of the potential for HEV to present as either acute or chronic infection, with mild or absent clinical symptoms. Overall, HEV testing should be considered in at-risk immunosuppressed patients with hematological disorders, even when the liver function test reveals only moderate elevation or should better be performed as part of routine testing.
【저자키워드】 zoonosis, Genotype, transfusion, hepatitis E virus,