). We report identifying a novel circovirus infecting humans, tentatively named human circovirus type 1 , and its role in causing liver damage in a solid organ transplant recipient.. Clinical and laboratory data over time for a heart-lung transplant patient in France who had cytolytic hepatitis caused by HCirV-1 develop. A–C) Monitoring of patient over time: A) viral loads;...
A woman, 61 years of age, sought treatment in France with cytolytic hepatitis of unknown etiology. The patient had received a heart-lung transplant 17 years earlier because of Eisenmenger syndrome related to ventricular septal defect. Her maintenance immunosuppressive regimen included tacrolimus, mycophenolate mofetil, and prednisone. She had received pulse steroids 16 months before the hepatitis occurred to treat acute lung allograft dysfunction.
Four months after that hospitalization, hepatitis worsened; transaminase serum levels increased to up to 40 times the normal upper limit , leading to hospital readmission. The patient was asymptomatic except for recent weight loss but without biological severity because the prothrombin time level was normal.
Pathological examination of a liver biopsy showed lobular hepatitis, slightly inflammatory, without epithelioid granuloma, substantial portal inflammation and fibrosis, or lymphoproliferation . Results of Ziehl, EBV, CMV, and adenovirus stains and bacteriological examinations of the biopsy sample, including mycobacterial cultures and PCR, broad-range 16S ribosomal RNA gene PCR, were negative.
In November 2022, the patient’s clinical condition was stable, and we noted complete recovery from cytolysis. In the context of her recent infectious diseases, we minimized the patient’s immunosuppressive treatment, discontinuing mycophenolate mofetil . When we tried to ascertain possible sources of her HCirV-1 infection, the patient reported contact with 2 cats, both of which had contact with birds and rodents. HCirV-1 PCR was negative in the feces of the cats 2 months after her diagnosis.
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