Journal of Clinical Virology - Volume 82 - Supplement 1 - September 2016

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Abstracts / Journal of Clinical Virology 82S (2016) S1–S142 S79
likely major reservoirs in domestic pigs, wild boars and deer.
HEV infections have been associated with self-limiting hepatitis.
However, an increasing number of chronic infections have been
described in immunosuppressed individuals, such as organ trans-
plant recipients, in whomHEV infection can cause progressive liver
fibrosis, cirrhosis and subsequent liver failure, which is particularly
relevant for liver transplant recipients. The aim of this study was to
assess the prevalence of HEV infection in liver transplant recipients
in a Portuguese reference center for liver transplantation.
Methods: A total of 23 individuals (children and adults) trans-
planted between 2003 and 2015 was assessed for evidence of HEV
infection by testing post-transplant plasma samples for HEV RNA.
Additionally, previous and subsequent plasma samples were also
tested in all individuals with evidence of HEV infection to evalu-
ate the possibility of chronic infection (defined by persisting HEV
RNA in plasma for 6 months or more). Epidemiologic and clini-
cal data at the time of sample collection were recorded. Viral RNA
was extracted from plasma samples using the QIAamp Viral RNA
Mini Kit (Qiagen) and amplified by real time RT-PCR using an assay
targeting the ORF2/3 overlapping region (Ceeram).
Results: Median age at the time of liver transplant was 28 years
old andmedian time since transplantation to sample collectionwas
69 months. Median value of alanine aminotransferase (ALT) and
aspartate aminotransferase (AST) at the time of sample collection
was 54U/L and 53U/L, respectively. Overall, 8.7% (n = 2) of the indi-
viduals had evidence of post-transplant HEV infection. Of these, one
individual had detectable HEV RNA in plasma, between months 79
and 80 post-transplant, andmedian value of ALT andAST at the time
of positive samples was 198U/L and 99U/L, respectively. This indi-
vidual underwent antiviral therapy with ribavirin and successfully
cleared the virus. The other individual had detectable HEV RNA in
plasma 113months after transplant, whichpersisted for 13months,
and therefore, was considered as chronically infected. Median value
of ALT andAST at the time of positive sampleswas 68U/L and60U/L,
respectively. A reduction in immunosuppression (tacrolimus) was
attempted to clear the virus, however, sustained viral clearancewas
only achieved after antiviral therapy with ribavirin.
Conclusion: Although the overall prevalence of HEV infection
was relatively low (8.7%), the results of this study demonstrate that
liver transplant recipients in Portugal have a risk for HEV infection.
Supporting this evidence is the recently described high prevalence
of HEV in domestic pigs and wild boars in Portugal, which have
been described as the most likely sources of infection in developed
countries. Moreover, to our knowledge, this study describes the
first case of chronic HEV infection in liver transplant recipients in
Portugal. In conclusion, HEV screening should be considered in the
liver transplant setting, particularly in the differential diagnosis of
graft hepatitis of an unclear etiology.
Abstract no: 301
Presentation at ESCV 2016: Poster 117
The frequency of occult HBV infection in
Eskisehir region of Turkey between 2001 and
2015
T. Us ∗, N. Kasifoglu, M. Aslan, Y. Akgun
Esksehir Osmangazi University, Faculty of Medicine,
Department of Microbiology, Eskisehir, Turkey
Occult HBV infection (OBI) is characterized by the detection of
HBV DNA in low levels in serum and peripheral blood mononuclear
cells and/or in the liver, in the absence of detectable hepatitis B sur-
face antigen (HBsAg). The prevalence of occult HBV infections varies
among patient populations tested. It depends on the prevalence of
HBV infection in populations, sensitivity of the assay employed in
routine serological or nucleic acid test screening and also the nature
of biological material tested.
In this study, we searched the presence of occult HBV infec-
tion in patients diagnosed as viral hepatitis B infection. A total of
16853 serum samples were tested for HBV DNA by Real-time PCR
technique and for serological viral markers (HBV, HCV and HDV)
by ELISA assay (AxSYM and Architect ˙I2000SR (Abbott) between
2001 and 2015. Alanine aminotransferase (ALT) and aspartate
aminotransferase (AST) levels were investigated in the sera of HBV
DNA positive and HBsAg negative patients. We detected HBsAg
negativity in 105 (2.6%) of 4036 patients, of whom HBV DNA
was positive. The minimum and maximum DNA levels were as
1 ×101–1.7 ×108 copies/ml. Anti-HBc IgM was negative in all of
these 105 patients. Among 105 patients, 31 (29.5%) were positive
for only anti-HBc, 3 (2.8%) were positive for anti-HBs, 16 (15.2%)
were positive for both anti-HBs and anti-HBc in their sera. Thir-
teen (12.3%) of all patients were negative for serological markers
of HBV infection. Among 105 patients, five patients were anti-HCV
positive. All of the patients were negative for anti-HDV. Forty (38%)
and thirty-eight (36.1%) patients had abnormal ALT and AST levels;
respectively. Nineteen (18%) patients were immunocompromised
individuals.
Detection of HBV DNA with highly sensitive and specific PCR
techniques is important because OBI is usually associated with low
levels of HBV DNA. OBI should be carefully assessed in certain clin-
ical statements: HBV infection transmission (via blood transfusion
or solid organ transplantation), liver disease progression, hepato-
cellular carcinoma onset, and HBV reactivation.
Abstract no: 317
Presentation at ESCV 2016: Poster 118
Anti-HAV IgG seroprevalence in Lisbon region
residents: Preliminary results from the National
Serological Survey 2015–2016
H. Cortes-Martins ∗, R. Matos , S. Moura ,
L. Almeida erreira anita antos
S. Pinto , B. Nunes , R. Roquette , C. Cardoso ,
L. Brum , P. Palminha
1 National Institute of Health, Department of
Infectious Diseases, United States
2 National Institute of Health, Department of
Epidemiology, United States
3 Dr. Joaquim Chaves Clinical Laboratory, Portugal
4 Labco Group, India
Background: Data from developed countries have shown a
decrease in hepatitis A virus (HAV) incidence over time as a con-
sequence of economic and sanitation levels improvement. WHO
classifies Western European region, where Portugal is included, as
a lowendemicity area for hepatitis A. The presence of immunoglob-
ulin G (IgG) antibodies to HAV in serum is a marker of past infection
or vaccine immunization and is used to assess seroprevalence.
The 3rd National Serological Survey 2015–2016 (NSS), funded
by Iceland, Liechtenstein and Norway through the EEA Grants,
was designed to study the immunity of Portugal’s residing popula-
tion for vaccine-preventable diseases. Although it has never been
included in the National Vaccination Programme, hepatitis A vac-
cine is available in Portugal since 1998.