Table 1 Clinical findings, laboratory values and HEV ORF2 IHC on autopsy kidneys, patients 1-4²⁴

Patient 1

Patient 2

Patient 3

Patient 4

HEV genotype

HEV-3h_s

HEV-3h_s

HEV-3

HEV-3h_s

Age: 63 ± 5 years Sex: 3 males, 1 female

50−59

50–59

60–69

70–79

History of liver disease

chronic HEV infection

cirrhosis due to NASH

cirrhosis due to NASH/ASH

cirrhosis due to ASH

Viral load in liver

4.4 × 10⁶

n.a.

n.a

n.a

History of kidney disease

IgA nephropathy, kidney TPL

unknown

unknown

unknown

Viral load in kidney

0

n.a.

n.a.

n.a

Immunosuppression (IS)

yes

no

no

no

 basis IS / add on IS

tacrolimus, MMF / corticosteroids

-

-

-

Urea max. (mmol/)

hemodialysis

n.a.

25

n.a.

Creatinine max. (umol/l)

573

188

180

> 200

eGFR min. (ml/min/1.73m²)

hemodialysis

33

25

n.a.

Serum albumin min. (g/l)

11

26

26

24

Proteinuria

yes

yes

yes

n.a.

HEV RNA in blood

1.2 × 10⁸ IU/mL

4.0 × 10⁶ IU/mL

4.6 × 10⁴ IU/mL

2.2 × 10³ IU/mL

HEV ORF2 immunohistochemistry on autopsy kidney (scale bar: 50 µm)

Staining intensity, semiquantitative

+++

+

+

+