Log in with your email address username.


Important notice

doctorportal Learning is on the move as we will be launching a new website very shortly. If you would like to sign up to dp Learning now to register for CPD learning or to use our CPD tracker, please email support@doctorportal.com.au so we can assist you. If you are already signed up to doctorportal Learning, your login will work in the new site so you can continue to enrol for learning, complete an online module, or access your CPD tracker report.

To access and/or sign up for other resources such as Jobs Board, Bookshop or InSight+, please go to www.mja.com.au, or click the relevant menu item and you will be redirected.

All other doctorportal services, such as Find A Doctor, are no longer available.

First confirmed case of transfusion-transmitted hepatitis E in Australia

- Featured Image

Clinical record

In July 2014, a 6-year-old boy underwent a split liver transplant following liver failure of unknown cause and received 18 blood components peri-operatively. In January 2015, routine monitoring revealed elevated levels of serum liver enzymes (alanine aminotransferase, 289 U/L; reference interval, < 30 U/L). Two biopsies showed possible but inconclusive evidence of rejection, and alanine aminotransferase levels continued to rise, reaching 1170 U/L, despite anti-rejection treatment. Hepatitis E virus (HEV) testing was performed on a third biopsy sample and HEV RNA was detected by reverse transcription polymerase chain reaction. Retrospective testing of the patient’s blood and liver samples showed that he was HEV RNA negative before transplantation, but HEV RNA positive in post-transplant blood from September 2014. After 3 months of ribavirin therapy, the patient’s liver enzyme levels normalised and HEV RNA became undetectable.

The patient had not consumed uncooked pork products and had no history of contact with swine, a known zoonotic HEV source, or overseas travel. HEV RNA was not detected in donor liver samples tested retrospectively. In July 2015, the case was referred to the Australian Red Cross Blood Service (Blood Service) for investigation into possible transmission by transfusion. HEV RNA and IgG testing was performed on archived samples from all…