Hepatitis E Virus and Renal Transplantation

Sepehrvand et al. demonstrated a considerable seroprevalence rate of anti-hev in iranian kidney transplant recipients (1). the impact of hev infection on renal transplantation and the risk of chronic hev infection in this group are debated—issues that i would like to discuss. hepatitis e virus (hev) was first discovered in new delhi, india, in 1955 (2). the virus is transmitted via the oral-fecal route (3). other possible routes of transmission include blood transfusions, drug vertical transmission, person-to-person contact, and zoonotic transmission (4, 5). the frequency of hev transmission by non-fecal-oral routes remains unknown (2, 6). in endemic areas, exposure occurs in childhood (7, 8). in high-income countries, most cases of hepatitis e appear to be acquired locally and are not imported from endemic regions. in these areas, it likely has a zoonotic origin (9). in immunocompetent individuals, hepatitis e is a self-limited disease. however, hev can cause chronic infection in solid organ transplants (10, 11), patients who receive chemotherapy (12), and hiv-infected persons (13).