Table 2.
Characteristics of studies included in the systematic review
|
Ref.
|
Country
|
Type
|
n
(%)
|
Organ
|
Age
|
Male
|
White
|
HEV
|
Confirmed test
|
Acute HEV
|
Death
|
Outcome
|
Follow-up
|
| Kamar et al[19], 2011 | Monaco | R | 85 | UD | - | - | - | 65.9% (total; 56/85). 32.1% (18/85) had clearance. 0% (0/18) reactivation | Persistently elevated LFTs and positive HEV-RNA | 0% | - | Factors associated with chronic HEV infection: Tacrolimus (OR 1.89; 1.49-1.97). Low platelet (OR 1.02; 1.00-1.10) | 6 mo |
| Legrand-Abravanel et al[35], 2011 | France | R | 700 | Liver (n = 171), kidney (n = 529) | 52 | 65.6% | - | 15.1% (total; 106/700). 14.6% (25/171) for LTx. 15.3% (81/529 for KTx. 5.6% (de novo; 34/601). 0% (0/17) reactivation | Positive HEV IgG, IgM (Adaltis assay) or HEV-RNA | 2.8% (17/611). 2.7% (4/150) for LTx. 2.8% (13/461) for KTx | - | - | 22 mo |
| Pischke et al[22], 2012 | Germany | P | 274 | Heart | 57 | 80% | - | 12.8% (total; 35/274). 7.3% (de novo; 20/274) | Positive HEV IgG (MP assay) or HEV-RNA | - | - | Heart transplant recipients had significantly higher seroprevalence of HEV-IgG than healthy individuals | 8 mo |
| Crossan et al[21], 2014 | Scotland | P | 317 | UD | 56.4 | 93.4% | - | 14.2% (total; 45/317) | Positive HEV IgG or IgM (Wantai assay) | 0.9% (3/317) | - | Factors associated with chronic HEV infection: HBV coinfection (OR 7.4; 1.4-37). IgG positive is associated with HCC (OR 2.3; 1.1-4.8) | - |
| Mallet et al[36], 2013 | France | R | 267 | Liver | - | - | - | 31% (total; 83/267) | Positive HEV IgG (Wantai assay) | - | - | - | - |
| Pischke et al[37], 2014 | Germany | R | 95 | Lung | - | - | - | 5.3% (total; 5/95) | Positive HEV IgG (MP assay) | - | - | - | - |
| Riezebos-Brilman et al[38], 2013 | Netherlands | R | 468 | Lung | 40 | 60% | - | 2.1% (total; 10/468) | Positive HEV-RNA | - | 0.4% | - | 6.5 mo |
| Abravanel et al[39], 2014 | France | P | 263 | Liver (n = 52), kidney (n = 211) | 53 | 64.3% | - | 38.4% (total; 101/263). 42.3% for LTx (22/52). 37.4% for KTx (79/211). 1.9% (de novo; 3/162) | Positive HEV IgG, IgM (Wantai assay) or HEV-RNA | - | - | - | 12 mo |
| Buffaz et al[40], 2014 | France | R | 206 | Liver | 41.1 | 63.0% | - | 36.4% (total; 75/206). 5.3% (de novo; 11/206) | Positive post-transplant HEV IgG, IgM (Wantai assay) or HEV-RNA | - | - | - | 32.8 mo |
| Riveiro-Barciela et al[20], 2014 | Spain | R | 625 | Liver (n = 332), kidney (n = 296), dual (n = 6) | 54.5 | 60.8% | - | 5.8% (total; 36/625). 3.7% (11/296) for KTx. 7.4% (25/332) for LTx | Positive HEV IgG (MP assay) | - | - | Risk factors associated with HEV infection: Cirrhosis (OR 7.6; 4.4-13.1). Liver transplantation (OR 3.1; 1.8-5.4). HIV infection (OR 2.4; 1.3-4.4) | - |
| De Nicola et al[41], 2015 | Italy | R | 79 | Liver | 55 | - | - | 33% (total; 26/79). 5.7% (de novo; 3/53) | Positive HEV IgG, IgM (Wantai assay), HEV-RNA | 0% | - | - | 12 mo |
| Magnusson et al[42], 2015 | Sweden | P | 62 | Lung | 55 | 37.5% | 100% | 14.8% (total; 8/54). De novo N/A | Positive HEV IgG (recomWell assay) | 25% (2/8) | 17.8% | - | 12 mo |
| Sherman et al[43], 2017 | United States | P | 171 | Liver (n = 70), kidney (n = 101) | - | - | - | 19.9% (total; 34/171). 21.4% (15/70) for LTx. 18.8% (19/101) for KTx | Positive HEV IgG (Wantai assay) | 5.5% (3/55) for LTx. 0% for KTx | - | HIV-infected transplant recipients | 24 mo |
| Erken et al[17], 2018 | Netherlands | R | 677 | Kidney | - | - | - | 0.7% (de novo; 2/300) | Positive HEV-RNA | - | - | Subjects are patients with ALT elevations | - |
| Reekie et al[18], 2018 | United Kingdom | R | 611 | Liver (n = 262), kidney (n = 349) | - | - | - | 0.5% (total; 3/611) | Positive HEV-RNA | - | - | - | 36 mo |
| Samala et al[44], 2018 | United States | R | 232 | Liver (n = 208), kidney (n = 10), both (n = 10), intestine (n = 4) | 58 | 65% | 70% | 19.4% (total; 45/232) | Positive IgG, IgM (Wantai assay) or HEV-RNA | - | - | HEV seroprevalence was associated with older age and patients with the diagnosis of alcohol- or NAFLD-associated liver failure | - |
| Darstein et al[45], 2020 | Germany | R | 74 | Liver | 55 | 62.2% | - | 28.8% (total; 21/73) | Positive HEV IgG (recomWell assay) or HEV-RNA | - | - | - | - |
| Komolmit et al[46], 2020 | Thailand | P | 108 | Liver | 58 | 69% | 0% | 44% (total; 48/108) | Positive IgG, IgM (Wantai assay) or HEV-RNA | 2% (1/48) | 0.9% | - | 12 mo |
| Wang et al[23], 2020 | China | R | 408 | Liver | 50 | 81.1% | 0% | 41.2% (total; 168/408). 16.9% (de novo; 69/408) | Positive HEV-RNA more than 6 months | 13.7% (56/408) | - | Alcoholic cirrhosis (OR 5.324; 1.36-20.98). Liver failure (OR 23.76; 2.78-203.08). Graft rejection (OR 0.217; 0.06-0.74) | 13.7 mo |
| Zanotto et al[47], 2020 | Italy | R | 120 | Liver | - | - | - | 19.2% (total; 23/120) | Positive HEV IgG, IgM (N/A assay) or HEV-RNA | - | - | - | - |
UD: Undifferentiated; HEV: Hepatitis E virus; LFTs: Liver function test; OR: Odds ratio; LTx: Liver transplant; IgG: Immunoglobulin G; MC: Multicenter; IgM: Immunoglobulin M; KTx: Kidney transplant; HCC: Hepatocellular carcinoma; HIV: Human immunodeficiency virus; ALT: Alanine aminotransferase; R: Retrospective; NAFLD: Non-alcoholic fatty liver disease; MP: Methylparaben.