Transmission of Hepatitis E Virus by Plasma Exchange: A Case Report
Authors: Vincent Mallet, Rebecca Sberro-Soussan, Anais Vallet-Pichard, Anne-Marie Roque-Afonso, Stanislas Pol
Journal: Annals of Internal Medicine (2016)

Letters21 June 2016Transmission of Hepatitis E Virus by Plasma Exchange: A Case ReportVincent Mallet, MD, PhD, Rebecca Sberro-Soussan, Anais Vallet-Pichard, MD, Anne-Marie Roque-Afonso, MD, PhD, and Stanislas Pol, MD, PhDVincent Mallet, MD, PhDFrom Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin Port Royal, Institut Pasteur, Unité Mixte de Service 020, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Necker Paris, France; Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin Port Royal, Institut Pasteur, Unité Mixte de Service 020, Paris, France; Université Paris Sud, Assistance Publique-Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale unité 1193, Villejuif, France., Rebecca Sberro-SoussanFrom Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin Port Royal, Institut Pasteur, Unité Mixte de Service 020, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Necker Paris, France; Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin Port Royal, Institut Pasteur, Unité Mixte de Service 020, Paris, France; Université Paris Sud, Assistance Publique-Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale unité 1193, Villejuif, France., Anais Vallet-Pichard, MDFrom Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin Port Royal, Institut Pasteur, Unité Mixte de Service 020, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Necker Paris, France; Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin Port Royal, Institut Pasteur, Unité Mixte de Service 020, Paris, France; Université Paris Sud, Assistance Publique-Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale unité 1193, Villejuif, France., Anne-Marie Roque-Afonso, MD, PhDFrom Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin Port Royal, Institut Pasteur, Unité Mixte de Service 020, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Necker Paris, France; Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin Port Royal, Institut Pasteur, Unité Mixte de Service 020, Paris, France; Université Paris Sud, Assistance Publique-Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale unité 1193, Villejuif, France., and Stanislas Pol, MD, PhDFrom Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin Port Royal, Institut Pasteur, Unité Mixte de Service 020, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Necker Paris, France; Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin Port Royal, Institut Pasteur, Unité Mixte de Service 020, Paris, France; Université Paris Sud, Assistance Publique-Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale unité 1193, Villejuif, France.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-0502 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Hepatitis E virus (HEV) is most often transmitted through the fecal–oral route in contaminated drinking water or food, but it can also be transmitted by blood and blood products (1). The virus usually causes an acute, self-limited illness with symptoms typical of other hepatitis viruses; however, fulminant disease is possible and chronic infection can occur in immunosuppressed persons.Objective: To report transmission of HEV to a kidney transplant recipient through plasma exchange.Case Report: Our patient was a 48-year-old North African woman with vascular nephropathy. After 3 years of hemodialysis, she received her first kidney transplant from a deceased ...References1. Hewitt PE, Ijaz S, Brailsford SR, Brett R, Dicks S, Haywood B, et al. Hepatitis E virus in blood components: a prevalence and transmission study in southeast England. Lancet. 2014;384:1766-73. [PMID: 25078306] doi:10.1016/S0140-6736(14)61034-5 CrossrefMedlineGoogle Scholar2. Montgomery RA, Lonze BE, King KE, Kraus ES, Kucirka LM, Locke JE, et al. Desensitization in HLA-incompatible kidney recipients and survival. N Engl J Med. 2011;365:318-26. [PMID: 21793744] doi:10.1056/NEJMoa1012376 CrossrefMedlineGoogle Scholar3. Zhai L, Dai X, Meng J. Hepatitis E virus genotyping based on full-length genome and partial genomic regions. Virus Res. 2006;120:57-69. [PMID: 16472882] CrossrefMedlineGoogle Scholar4. Gallian P, Lhomme S, Piquet Y, Sauné K, Abravanel F, Assal A, et al. Hepatitis E virus infections in blood donors, France. Emerg Infect Dis. 2014;20:1914-7. [PMID: 25340881] doi:10.3201/eid2011.140516 CrossrefMedlineGoogle Scholar5. Andonov A, Rock G, Lin L, Borlang J, Hooper J, Grudeski E, et al; Members of the Canadian Apheresis Group (CAG). Serological and molecular evidence of a plausible transmission of hepatitis E virus through pooled plasma. Vox Sang. 2014;107:213-9. [PMID: 24830322] doi:10.1111/vox.12156 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin Port Royal, Institut Pasteur, Unité Mixte de Service 020, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Necker Paris, France; Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin Port Royal, Institut Pasteur, Unité Mixte de Service 020, Paris, France; Université Paris Sud, Assistance Publique-Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale unité 1193, Villejuif, France.Disclaimer: The Agence Nationale de la Recherche paid for the serologic tests conducted during the study.Acknowledgment: The authors thank the patient for her altruistic decision to allow this article to focus on her case, with a view to helping others. The authors also thank Drs. Corouge and Bererhi for caring for the patient and Drs. Hauser and Beyloune (Etablissement Français du Sang) for performing the transfusional investigation.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0502.This article was published at www.annals.org on 1 March 2016. 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