CHIEN-HUI WUCHENG-MAW HOJIA-HUEI TSAIHSIN-YUN SUNREY-HENG HUPO-HUANG LEE2020-12-292020-12-2920171304-0855https://www.scopus.com/inward/record.uri?eid=2-s2.0-85019255084&doi=10.6002%2fect.2015.0031&partnerID=40&md5=415ab72022af3aa524c1fc00f029f384https://scholars.lib.ntu.edu.tw/handle/123456789/535591Chronic hepatitis in immunosuppressed patients because of infection with hepatitis E virus is increasingly recognized, but there is a paucity of knowledge about hepatitis E virus infection in solidorgan transplant recipients. Herein, we reported the first confirmatory case of hepatitis E virus genotype 4 infection in a 47-year-old woman who underwent a liver transplant recipient in Taiwan. The patient presented with unexplained hepatitis and severe jaundice. Hepatitis E virus RNA was present in serum and identified as the genotype 4 by reverse transcription polymerase chain reaction. Pathological findings revealed that prominent zone 3 canalicular and hepatocellular cholestasis with a few acidophilic bodies and giant cell transformation, which was typical of hepatitis E virus hepatitis. Even undergoing ribavirin treatment, she had worse cholestasis and recurrent urinary tract infections. She died from encephalopathy and sepsis 6 months after the initial presentation. So far, compared with genotype 3 hepatitis E virus hepatitis, genotype 4 hepatitis E virus infection in solidorgan transplant recipients has been reported less frequently in the literature, and that warrants further accumulation of experiences. ? Ba?kent University 2017 Printed in Turkey. All Rights Reserved.[SDGs]SDG3antibiotic agent; antifungal agent; antivirus agent; bilirubin; interferon; ribavirin; tacrolimus; virus RNA; virus RNA; adult; Article; case report; cause of death; female; fever; flu like syndrome; hepatitis C; hepatitis E; Hepatitis E virus; Hepatitis E virus genotype 4; human; human tissue; immunosuppressive treatment; intrahepatic cholestasis; jaundice; liver biopsy; liver cirrhosis; liver transplantation; middle aged; sepsis; urinary tract infection; adverse effects; biopsy; drug effects; fatality; genetics; genotype; hepatitis E; Hepatitis E virus; Hepatitis, Chronic; liver function test; liver transplantation; phenotype; predictive value; treatment outcome; virology; Antiviral Agents; Biopsy; Fatal Outcome; Female; Genotype; Hepatitis E; Hepatitis E virus; Hepatitis, Chronic; Humans; Liver Function Tests; Liver Transplantation; Middle Aged; Phenotype; Predictive Value of Tests; Ribavirin; RNA, Viral; Treatment Outcomejournal article10.6002/ect.2015.0031262217212-s2.0-85019255084