Multiple Introductions of Influenza A(H5N8) Virus into Poultry, Egypt, 2017

particularly when term approaches. The imbalance in T-cell immunity (Th1/Th2) has been proposed to be implicated in the progression of chronic HEV infection in immunocompromised pigs (7). This imbalance may explain the absence of cytolysis during pregnancy and the increased viral load observed despite discontinuation of infliximab. Conversely, after delivery, restoration of cellular immunity is commonly observed (11) and may have contributed to efficient clearance of the virus by hepatic cytolysis along with the reduced immunosuppression resulting from infliximab discontinuation. Despite reintroduction of infliximab when HEV RNA was still detectable, we observed spontaneous resolution of chronic hepatitis E, although immunosuppressive treatment at that time was identical to that previously implicated in the chronicity of infection.