Occult rat hepatitis E virus infection as a cause of cirrhosis and posttransplant recurrence: Insights into the role of metagenomics

American Journal of Transplantation 2026 Open access

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Authors: Jacques Fourgeaud, Nicolas Veyrenche, Illan Laloum, Jean-Philippe Jais, Camille Roger, Marion Rabant, Vincent Mallet, Aurélie Bèaufrere, Hélène Fontaine, Marianne Leruez‐Ville, François DURAND, Dany Anglicheau
DOI: 10.1016/j.ajt.2026.01.005
Cited by: 4
References: 9

Abstract

We report the case of a kidney-transplant recipient (2011) who developed persistent elevation of liver enzymes beginning in 2015. Extensive investigations including standard hepatitis E virus PCR failed to identify a cause. In 2019, she developed decompensated cirrhosis and underwent liver-kidney transplantation in 2021. Posttransplant, liver function tests remained abnormal. Given suspicion of an unidentified pathogen, metagenomic next-generation sequencing was performed on the graft and identified rat hepatitis E virus. Retrospective testing of native liver and serum samples confirmed infection since 2015. Ribavirin therapy resulted in normalization of liver enzymes and viral clearance.

Fields of Study & Subjects

Hepatitis Viruses Studies and Epidemiology Viral gastroenteritis research and epidemiology Travel-related health issues

Publication details

Journal / source
American Journal of Transplantation
Publisher
Elsevier BV
Volume
26
Issue
6
Pages
1491–1494
Publication date
10 January 2026
Language
EN