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Peer-reviewedCC BY-NC-NDInternal Medicine

A Transfusion-transmitted Chronic Hepatitis E Virus Infection after Allogeneic Bone Marrow Transplantation with Viral Clearance Following Immunosuppression Tapering

Abstract

A hepatitis E virus (HEV) infection is typically self-limiting in immunocompetent individuals, but it may cause chronic persistent or fulminant hepatitis in immunocompromised hosts. We report the case of a 62-year-old woman with myelofibrosis who developed chronic hepatitis E due to transfusion-transmitted HEV genotype 3 infection after allogeneic bone marrow transplantation, which was confirmed by positivity for anti-HEV IgA and HEV RNA, as well as the viral RNA sequence identity between the transfusion donor and recipient. Liver dysfunction appeared two months after transfusion and worsened despite tacrolimus escalation for suspected graft-versus-host disease, but it resolved after tacrolimus tapering alone. Although foodborne transmission is common, transfusion and other unidentified sources can also cause an HEV infection. An HEV should be considered when a patient shows posttransplant liver dysfunction.

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BibTeX
@article{sato2026transfusiontransmitted,
  title = {{A Transfusion-transmitted Chronic Hepatitis E Virus Infection after Allogeneic Bone Marrow Transplantation with Viral Clearance Following Immunosuppression Tapering}},
  author = {Keijiro Sato and Hiroko Kazumoto and Ami Tanaka and Hidekatsu Sakata and Shunya Sunohara and Shintaro Kazama and Hiroko Kaiume and Hiromitsu Mori and Toshimitsu Ueki},
  journal = {Internal Medicine},
  year = {2026},
  month = oct,
  doi = {10.2169/internalmedicine.6903-25},
  url = {https://www.jstage.jst.go.jp/article/internalmedicine/65/20/65_6903-25/_article},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - A Transfusion-transmitted Chronic Hepatitis E Virus Infection after Allogeneic Bone Marrow Transplantation with Viral Clearance Following Immunosuppression Tapering
AU  - Keijiro Sato
AU  - Hiroko Kazumoto
AU  - Ami Tanaka
AU  - Hidekatsu Sakata
AU  - Shunya Sunohara
AU  - Shintaro Kazama
AU  - Hiroko Kaiume
AU  - Hiromitsu Mori
AU  - Toshimitsu Ueki
PY  - 2026
DA  - 2026/10/15
JO  - Internal Medicine
DO  - 10.2169/internalmedicine.6903-25
UR  - https://www.jstage.jst.go.jp/article/internalmedicine/65/20/65_6903-25/_article
AB  - A hepatitis E virus (HEV) infection is typically self-limiting in immunocompetent individuals, but it may cause chronic persistent or fulminant hepatitis in immunocompromised hosts. We report the case of a 62-year-old woman with myelofibrosis who developed chronic hepatitis E due to transfusion-transmitted HEV genotype 3 infection after allogeneic bone marrow transplantation, which was confirmed by positivity for anti-HEV IgA and HEV RNA, as well as the viral RNA sequence identity between the transfusion donor and recipient. Liver dysfunction appeared two months after transfusion and worsened despite tacrolimus escalation for suspected graft-versus-host disease, but it resolved after tacrolimus tapering alone. Although foodborne transmission is common, transfusion and other unidentified sources can also cause an HEV infection. An HEV should be considered when a patient shows posttransplant liver dysfunction.
SN  - 1349-7235
SN  - 0918-2918
ER  -