Acute Hepatitis E–Associated Acute Pancreatitis

Raj, Mithun; Kumar, K. Kishore; Ghoshal, Uday C; Saraswat, Vivek A.; Aggarwal, Rakesh; Mohindra, Samir

doi:10.1097/mpa.0000000000000402

Cited by 20 publications

(3 citation statements)

References 18 publications

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“…[11] While none of the hepatitis virus-infected AP patients in the NIS database had HEV, at least 14 case studies of HEV infection associated with AP have been reported in the literature, mainly describing young adults in areas endemic for the virus. [22] A review study identified 55 cases of HEV-associated AP, among which about one-fifth were severe and overall mortality was 3.2%. [23] Kamar et al [24] reported that HEV, despite its association with AP, was also associated with extrahepatic disorders, including hematologic disorders and autoimmune myocarditis and thyroiditis.…”

Section: Discussionmentioning

confidence: 99%

Impact of hepatitis virus infection on inpatient outcomes of acute pancreatitis: A population-based study

2023

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This study aimed to investigate the associations between hepatitis virus infection and inpatient outcomes of acute pancreatitis (AP). In this population-based, retrospective study, hospitalized patients with AP were identified in the 2005 to 2018 United States Nationwide Inpatient Sample database. Univariate and multivariable regression analyses were conducted to evaluate the associations between hepatitis virus infection, death/discharge against medical advice (DAMA), prolonged length of stay (LOS), and occurrence of life-threatening complications including ischemia/infarction of the intestine, portal vein thrombosis, acute organ failure, systemic inflammatory response syndrome, and hypovolemic shock. A total of 775,416 patients hospitalized for AP comprised the analytic cohort. Amongst, 26,407 subjects (3.4%) had been diagnosed hepatitis virus infection, whereas 749,009 (96.6%) had not. Mean age of the subjects was 51.4 years. After adjusting for relevant confounders, hepatitis virus infection was significantly and independently associated with increased odds of death/DAMA (aOR = 1.33, 95% CI = 1.26–1.40), prolonged LOS (aOR = 1.12, 95%CI = 1.09–1.16), and acute organ failure (aOR = 1.06, 95% CI = 1.01–1.12). In patients with AP, hepatitis virus infection is an independent predictor of worse inpatient outcomes in terms of more death/DAMA, prolonged LOS, and life-threatening complications. The findings may help risk stratification and the development of proper strategies for managing patients suffered from AP.

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Section: Discussionmentioning

confidence: 99%

Impact of hepatitis virus infection on inpatient outcomes of acute pancreatitis: A population-based study

2023

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“…Lastly, several cases of HEV-induced acute pancreatitis have been reported [87][88][89][90][91]. A single-center study from India found that 2.1% (16/790) of patients with acute pancreatitis had serological evidence of a recent HEV infection with no other discernible cause of pancreatitis [92]. The authors suggested that this was due to edema developing in the ambulla of Vater, which then obstructs pancreatic fluid flow.…”

Section: Renal Manifestationsmentioning

confidence: 99%

Clinical Manifestations, Pathogenesis and Treatment of Hepatitis E Virus Infections

Lhomme

Marion

Abravanel

et al. 2020

JCM

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Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis throughout the world. Most infections are acute but they can become chronic in immunocompromised patients, such as solid organ transplant patients, patients with hematologic malignancy undergoing chemotherapy and those with a human immunodeficiency virus (HIV) infection. Extra-hepatic manifestations, especially neurological and renal diseases, have also been described. To date, four main genotypes of HEV (HEV1-4) were described. HEV1 and HEV2 only infect humans, while HEV3 and HEV4 can infect both humans and animals, like pigs, wild boar, deer and rabbits. The real epidemiology of HEV has been underestimated because most infections are asymptomatic. This review focuses on the recent advances in our understanding of the pathophysiology of acute HEV infections, including severe hepatitis in patients with pre-existing liver disease and pregnant women. It also examines the mechanisms leading to chronic infection in immunocompromised patients and extra-hepatic manifestations. Acute infections are usually self-limiting and do not require antiviral treatment. Conversely, a chronic HEV infection can be cleared by decreasing the dose of immunosuppressive drugs or by treating with ribavirin for 3 months. Nevertheless, new drugs are needed for those cases in which ribavirin treatment fails.

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“…These include neurological disorders such as Guillain-Barré syndrome, neuralgic amyotrophy, and meningoencephalitis [31]; kidney disorders such as cryoglobulinemic glomerulonephritis [32], cryoglobulinemic membranoproliferative glomerulonephritis [33], and exacerbation of IgA nephropathy [34]; and hematological disorders including thrombotic thrombocytopenic purpura [35][36][37] and aplastic anemia [38]. Other extrahepatic manifestations attributed to HEV infection comprise pancreatitis [39][40][41], myocarditis [42,43], and thyroiditis [44,45].…”

Section: Introductionmentioning

confidence: 99%

Three Distinct Reporter Systems of Hepatitis E Virus and Their Utility as Drug Screening Platforms

Primadharsini,

Nagashima,

Nishiyama

et al. 2023

Viruses

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The hepatitis E virus (HEV) is increasingly acknowledged as the primary cause of acute hepatitis. While most HEV infections are self-limiting, cases of chronic infection and fulminant hepatitis necessitate the administration of anti-HEV medications. However, there is a lack of specific antiviral drugs designed for HEV, and the currently available drug (ribavirin) has been associated with significant adverse effects. The development of innovative antiviral drugs involves targeting distinct steps within the viral life cycle: the early step (attachment and internalization), middle step (translation and RNA replication), and late step (virus particle formation and virion release). We recently established three HEV reporter systems, each covering one or two of these steps. Using these reporter systems, we identified various potential drug candidates that target different steps of the HEV life cycle. Through rigorous in vitro testing using our robust cell culture system with the genotype 3 HEV strain (JE03-1760F/P10), we confirmed the efficacy of these drugs, when used alone or in combination with existing anti-HEV drugs. This underscores their significance in the quest for an effective anti-HEV treatment. In the present review, we discuss the development of the three reporter systems, their applications in drug screening, and their potential to advance our understanding of the incompletely elucidated HEV life cycle.

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Acute Hepatitis E–Associated Acute Pancreatitis

Abstract: Acute pancreatitis associated with hepatitis E is not uncommon and usually has good prognosis.

Cited by 20 publications

References 18 publications

Impact of hepatitis virus infection on inpatient outcomes of acute pancreatitis: A population-based study

Impact of hepatitis virus infection on inpatient outcomes of acute pancreatitis: A population-based study

Clinical Manifestations, Pathogenesis and Treatment of Hepatitis E Virus Infections

Three Distinct Reporter Systems of Hepatitis E Virus and Their Utility as Drug Screening Platforms

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