Prévalence de l’hépatite E au cours du suivi des patients transplantés rénaux et hépatiques en Guadeloupe

Abstract : Introduction: Hepatitis E is the leading cause of acute hepatitis in France, however we have very little data in West Indies. The objective of our study is to determine the prevalence of hepatitis E during the follow-up of renal (TR) and liver (TH) transplant recipients in Guadeloupe and to determine the possible modes of transmission. Materials and methods: In this preliminary study, 81 patients were included and analyzed between March and July 2018. The search for the virus was carried out by Wantai ELISA (IgM + IgG) and HBV blood PCR. Results: The patients were for 93.8% Caribbean, male (62.9%) with a median age at the graft of 51 years [15-71], and predominantly TR (79%). Immunosuppressive treatments were well tolerated. The prevalence of HEV IgG was 4.94% (4 cases). No patient was IgM or HRV PCR positive. The comparative study of HEV + cases with HEV controls showed that the cases were significantly older at the time of the transplant (62.5 vs 50 years, p = 0.0003) with a shorter immunosuppression delay (18 vs 61 month, p = 0.024). There was no clinico-biological difference, nor according to the treatment used. The risk factors for exposure identified were a travel tendency or birth in a high endemic area for HEV (p = 0.07) (p = 0.09), a consumption of homemade blood sausage (p = 0.06), and a history of transfusion (p = 0.089). There was no evidence of over-risk in hemodialysis patients (p> 0.17) or type of sexual practice (p> 0.66). Conclusion: The seroprevalence of anti-HEV IgG in TR and TH in Guadeloupe is low, estimated at 4.94%, indicating an old infection. Systematic screening of HEV serology before and after transplantation should be recommended. Continued monitoring of this cohort will be useful to ensure the absence of chronic infection.
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Marion Figeac. Prévalence de l’hépatite E au cours du suivi des patients transplantés rénaux et hépatiques en Guadeloupe. Hépatologie et Gastroentérologie. 2018. ⟨dumas-02063834⟩

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