A Transfusion-transmitted Chronic Hepatitis E Virus Infection after Allogeneic Bone Marrow Transplantation with Viral Clearance Following Immunosuppression Tapering.

IF 1.1

Internal medicine (Tokyo, Japan) Pub Date : 2026-10-15 Epub Date: 2026-03-03 DOI:10.2169/internalmedicine.6903-25

Keijiro Sato, Hiroko Kazumoto, Ami Tanaka, Hidekatsu Sakata, Shunya Sunohara, Shintaro Kazama, Hiroko Kaiume, Hiromitsu Mori, Toshimitsu Ueki

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Abstract

A hepatitis E virus (HEV) infection is typically self-limiting in immunocompetent individuals, but it may cause chronic persistent or fulminant hepatitis in immunocompromised hosts. We report the case of a 62-year-old woman with myelofibrosis who developed chronic hepatitis E due to transfusion-transmitted HEV genotype 3 infection after allogeneic bone marrow transplantation, which was confirmed by positivity for anti-HEV IgA and HEV RNA, as well as the viral RNA sequence identity between the transfusion donor and recipient. Liver dysfunction appeared two months after transfusion and worsened despite tacrolimus escalation for suspected graft-versus-host disease, but it resolved after tacrolimus tapering alone. Although foodborne transmission is common, transfusion and other unidentified sources can also cause an HEV infection. An HEV should be considered when a patient shows posttransplant liver dysfunction.

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输血传播的慢性戊型肝炎病毒感染异体骨髓移植后病毒清除免疫抑制逐渐减少。

戊型肝炎病毒（HEV）感染在免疫功能正常的个体中通常是自限性的，但它可能在免疫功能低下的宿主中引起慢性持续性或暴发性肝炎。我们报告了一例62岁的骨髓纤维化妇女，她在异基因骨髓移植后因输血传播的HEV基因3型感染而发展为慢性戊型肝炎，通过抗HEV IgA和HEV RNA阳性以及输血供者和受体之间的病毒RNA序列同源性证实了这一点。输血后两个月出现肝功能障碍，尽管他克莫司因疑似移植物抗宿主病而增加了肝功能障碍，但在他克莫司单独减量后肝功能障碍消退。虽然食源性传播很常见，但输血和其他不明来源也可引起戊型肝炎感染。当患者出现移植后肝功能障碍时，应考虑HEV。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Internal medicine (Tokyo, Japan)

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