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Unexplained abnormal liver function in patients with primary antibody deficiency: could it be chronic hepatitis E infection?
  1. Omar E Mohamed1,
  2. Julie Jones1,
  3. Husam Osman2,3,
  4. Aarnoud P Huissoon1
  1. 1 West Midlands Immunodeficiency Centre, Heartlands Hospital, Birmingham, UK
  2. 2 Department of Virology, Heartlands Hospital, Birmingham, UK
  3. 3 Public Health Laboratory Birmingham, Birmingham, UK
  1. Correspondence to Dr Omar E Mohamed, Department of Allergy and Immunology, Birmingham Heartlands Hospital, B9 5SS, Birmingham, UK; omar.mohamed{at}


Data from recent studies suggest rising incidence rate of hepatitis E virus (HEV) infection in the UK. HEV infection may take a severe and persistent course in immunocompromised patients, including transplant recipients on immunosuppressives, patients with HIV, haematological malignancies and in idiopathic CD4+ T lymphocytopenia. The prevalence of HEV in primary antibody deficiency (PAD) disorders is still unknown. The aim of this study was to investigate HEV infection in 27 patients with PAD with unexplained, persistently elevated liver enzymes. Although all the 27 patients tested negative for HEV-RNA, we would still strongly recommend that HEV should be considered in any immunodeficient patient with impaired liver function.

  • immunodeficiency
  • clinical infectious diseases
  • hepatitis

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  • Handling editor Stephen R A Jolles.

  • Contributors OEM, HO and APH designed the study. OEM and JJ collected the data and OEM wrote the manuscript. All authors were involved in the care of the patients and reviewed the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All the available anonymised data can be obtained by contacting the corresponding author.