@article {4750,
	title = {Donor-Derived Genotype 4 Hepatitis E Virus Infection, Hong Kong, China, 2018},
	volume = {25},
	year = {2019},
	month = {Mar},
	abstract = {Hepatitis E virus (HEV) genotype 4 (HEV-4) is an emerging
cause of acute hepatitis in China. Less is known about
the clinical characteristics and natural history of HEV-4 than
HEV genotype 3 infections in immunocompromised patients.
We report transmission of HEV-4 from a deceased
organ donor to 5 transplant recipients. The donor had been
viremic but HEV IgM and IgG seronegative, and liver function
test results were within reference ranges. After a mean
of 52 days after transplantation, hepatitis developed in all
5 recipients; in the liver graft recipient, disease was severe
and with progressive portal hypertension. Despite reduced
immunosuppression, all HEV-4 infections progressed to
persistent hepatitis. Four patients received ribavirin and
showed evidence of response after 2 months. This study
highlights the role of organ donation in HEV transmission,
provides additional data on the natural history of HEV-4 infection,
and points out differences between genotype 3 and
4 infections in immunocompromised patients.},
	author = {Sridhar, S and Cheng, Vincent CC and Wong, SC and Yip, Cyril CY and Wu, S and Lo, Anthony WI and Leung, KH and Mak, Winger WN and Cai, J and Li, X and Chan, Jasper FW and Lau, Susanna KP and Woo, Patrick CY and Lai, WM and Kwan, TH and Au, Timmy WK and Lo, CM and Wong, Sally CY and Yuen, KY}
}
