Phylogenetic Demonstration of Hepatitis E Infection Transmitted by Pork Meat Ingestion.

[]

Hepatitis E virus (HEV ) is responsible for a small number of acute hepatitis in developed countries . In this setting , HEV infection seems to be a zoonosis , although this has not been completely demonstrated . High morbidity and mortality associated with severe acute infections have been described , as well as the possible role of ribavirin therapy in those cases . We describe a case of acute hepatitis after pork meat ingestion in a patient with Waldeström macroglobulinemia with immunoglobulin A deficiency . Acute hepatitis E was diagnosed based on positive IgM anti-HEV antibodies and HEV RNA detected by real-time PCR . Because of clinical and analytical worsening , ribavirin was initiated , achieving sustained virologic response after 12 weeks of treatment . The phylogenetic analysis revealed the same HEV strain genotype 3 in both plasma and consumed meat samples , proving the zoonotic transmission . Regarding immunocompromised patients , acute hepatitis E can be associated to high morbidity and mortality rate , so dietetic recommendations may be needed to avoid the virus transmission .