• Elisa Zanotto, Massimo Rittà, Fabrizia Pittaluga, Silvia Martini, Marco Ciotti, Rossana Cavallo, and Cristina Costa.
• Unit of Microbiology and Virology, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy.
• Panminerva Med. 2023 Mar 1; 65 (1): 202220-22.

BackgroundAcute E hepatitis is usually a self-limited non-progressive disease; however, acute liver failure and death can occur in the presence of conditions such as pregnancy and chronic liver diseases. In immunocompromised individuals, such as transplant patients, acute hepatitis E virus (HEV) infection may evolve to chronic hepatitis with rapid progression to liver decompensation. At our center, serology for HEV is not routinely performed in transplant patients and serological status is investigated only based on clinical judgement.MethodsIn this study, seroprevalence of HEV was evaluated in 217 patients (120 liver transplant recipients and 97 individuals diagnosed with acute or chronic hepatitis). Molecular evaluation of HEV-RNA was also performed.ResultsThirteen patients (6%) showed positivity for HEV-IgG; in particular, 10/120 (8.3%), with concomitant presence of IgM and IgG in six and 3/97 (3.1%). None of the plasma samples tested by HEV-RNA was positive.ConclusionsAs the detectable RNA window is narrow and an undetectable HEV-RNA result does not exclude recent infection and the transplant context per se represents a risk factor for chronic infection in patients infected with HEV, a routine diagnostic workflow including HEV should be taken into consideration, increasing awareness and knowledge of the basic and clinical aspects of the disease.

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