Use of Real-Time Polymerase Chain Reaction (RT-PCR) to detect Hepatitis E Virus in liver transplantation patients

• Grant number: 19/27328-2
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): October 01, 2020
• Effective date (End): September 30, 2021
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Luiz Fernando Aranha Camargo
• Grantee: Paulo Gabriel Thomaz Matias da Silva
• Host Institution: Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE). Sociedade Beneficente Israelita Brasileira Albert Einstein (SBIBAE). São Paulo , SP, Brazil

Abstract

Hepatitis E virus (HEV) is a RNA virus enterically transmitted with five known subtypes that can cause human diseases. The World Health Organization estimates that 3.3 million people worldwide are infected by HEV and 56.000 people die annually due to HEV-related complications mainly in poor countries, where there is lack of sanitation and access to good health care. In Brazil few data suggest an ever increase rate of seroprevalence in different populations. The spectrum of dosease associated with HEV is wide, ranging from self-limiting hepatic acute liver disease to fulminant hepatitis with acute liver failure in pregnant women. In immunocompromised patients, specially those submitted to solid organ transplantation (SOT), the development of chronic disease - characterized by the persistence for more than 3 months of the HEV RNA in fecal or blood samples - is not rare, and can lead to cirrhosis. Liver transplant patients are more prone to developing complications of HEV infection but there are no data regrading HEV infection in Brazilina patients. As a major tool for HEV infection diagnosis, even more in immunocompromised patients that may not have seroconversion, polymerase chain reaction (PCR) and real-time polymerase chain reaction (RT-PCR) for HEV RNA research in stool and blood samples with good sensitivity and specificity plays a pivotal role. Among commercial tests, sensitivity may vary from 83% to 100%. The present study aims to assess the frequency HEV RNA positivity and to establish rates of prmary infection, graft transmission and reactivation of HEV infection in liver transplant patients. The study will prospectively collect blood samples from consecutive liver transplant patients at the Hospital Municipal Vila Santa Catarina - Dr. Gilson de C. Marques de Carvalho in Sao Paulo, Brazil for both antibody detection, RT-PCR for RNA amplification and HEV genotyping. All consecutive liver transplant patients older than 18 years and who formally consent to participate in the study during one year will be included.