Figure 1

Course of alanine transaminase and hepatitis E virus ribonucleic acid (HEV RNA) levels in the patient’s blood related to time indicated in months (M). Intervals and types of chronic lymphocytic leukemia therapy are shown. The time scale on the x-axis is related to time point “0 M”, when elevated transaminase concentrations were measured for the first time. This was also the time point at which rituximab was administered for the last time. The diagnosis of HEV infection by positive HEV polymerase chain reaction was first made at 6.5 months; HEV RNA concentrations at 0 and 5.25 months were measured retrospectively. Unfortunately, no earlier samples were available to show when HEV RNA first appeared in the blood.