A comparison of hepatitis E and A in a teaching hospital in Northwestern Romania. Acute hepatitis E – a mild disease?

Abstract

Background and aims. The incidence of locally acquired hepatitis E has increased in recent years across Europe. There are only few data on hepatitis E in Romania. The purpose of our research was to describe and compare hepatitis E and hepatitis A in adult patients.
 Methods. We included all consecutive adult patients with hepatitis E and hepatitis A admitted to the Teaching Hospital of Infectious Diseases, Cluj-Napoca, Romania between January 2017 and August 2019.
 Results. Hepatitis E incidence increased in 2018-2019 compared to 2017. The average age in hepatitis E (n=48) patients was 50.6 versus 39.1 years in hepatitis A (n=152, not including 262 minors) and two-thirds of the patients in both groups were men. Compared to hepatitis A, patients with hepatitis E presented significantly less modified AST and ALT, bilirubin, prothrombin index and INR levels. We found more comorbidities in hepatitis E patients adjusted for age and gender. Severe forms were found in 5 (3.3%) hepatitis A patients, compared to 12 (25%) of hepatitis E patients, of which 3 died. Ribavirin treatment was considered in 9 patients with acute-on-chronic hepatitis E, immunosuppression, cancers or neurological manifestations, showing good results.
 Conclusions. We observed an increased number of hepatitis E cases. Although laboratory results were less modified compared to hepatitis A, we found a higher number of severe hepatitis E cases. Ribavirin treatment seems to be beneficial in patients with preexisting conditions.

Enterically transmitted hepatitis in the third millennium in northeastern Romania

“…number of cases in Romania by 14% among medical staff and up to 28% among the general population (6,14). In this context, the aim of the present study was to evaluate the most recent epidemiological, clinical, biological and therapeutic data concerning HAV and HEV infections based on clinical practice at 'Sf.…”

“…Located in southeastern Europe, Romania is part of this globalization process due to a growing number of foreign visitors or international food trade. Romania has an intermediate endemicity of HAV infection (14). On the other hand, the seroprevalence of HEV infection in Romania is still unknown.…”