Seroprevalence of hepatitis E among iranian renal transplant recipients

Renal transplant recipients are known to be susceptible to viral infections,
with more severe clinical presentations compared to healthy persons. Hepatitis E is
generally a self-limited disease, which is caused by hepatitis E virus. Recently, hepatitis
E has become more important in organ transplant recipients, because of new findings
regarding the potential for chronic infections in this patient group.
Objectives: This study aimed to evaluate the seroprevalence of anti-HEV IgG among kidney
transplant recipients in Urmia, in the north-western region of Iran.
Patients and Methods: 91 patients were selected randomly from amongst patients who
had undergone kidney transplantation in Urmia, Iran. Each patient was tested for the
presence of anti-HEV IgG antibody using an enzyme-linked immunosorbent assay
(ELISA, Dia.Pro; Diagnostic Bioprobes, Italy).
Results: 28 subjects (30.8%) were seropositive for anti-HEV IgG. Seropositive patients
were generally older than seronegative patients (P = 0.009). There was no correlation
between HEV infection and the level of education (P = 0.206), the history of blood
transfusion (P = 0.164), or history of pre-transplantation hemodialysis (P = 0.228).
There was no significant difference in the serum alanine aminotransferase (ALT) levels
of the anti-HEV seropositive and seronegative patients. Multinomial logistic regression
analysis indicated no significant relationship between HEV infection and increase
in ALT levels, even after controlling for treatment with azathioprine (P = 0.79, OR = 1.12;
95% CI: 0.45–2.76).
Conclusion: The anti-HEV IgG antibody has a high prevalence in Iranian kidney transplant
recipients, and it is significantly higher in comparison with previous studies in
the general population or in hemodialysis patients