Comparison of clinical manifestations and epidemiology between acute hepatitis A and acute hepatitis E in Taiwan

Su, Chien–Wei; Wu, Jaw Ching; Yi, Huang; Huo, Teh Ia; Huang, Yi Hsiang; Chen, Lin; Chang, Full Young; Lee, Shou Dong

doi:10.1046/j.1440-1746.2002.02858.x

Cited by 16 publications

(11 citation statements)

References 27 publications

(69 reference statements)

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“…There is a recruitment bias; the more severe patients had a liver biopsy. Nevertheless, prognosis of sporadic hepatitis E can be severe and probably more severe than in patients with endemic hepatitis E in part because it occurs in older patients [2,7,15,16]. They frequently have underlying liver disease and, at least in France, chronic alcohol consumption [11].…”

Section: Discussionmentioning

confidence: 99%

Liver histology in patients with sporadic acute hepatitis E: a study of 11 patients from South-West France

et al. 2007

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Hepatitis E virus is a ribonucleic acid (RNA) enterically transmitted virus that causes both epidemics and sporadic cases of acute hepatitis E in many countries of Asia and Africa. Domestically acquired (non-travel-associated) hepatitis E has been reported recently in many industrialized countries including the USA, Europe, and Japan. There is little information available on liver histology in these patients. We report a series of 11 patients with sporadic acute hepatitis E and needle liver histology in South-West France. Hepatitis E was diagnosed based on elevated transaminases (>10 upper limit normal) and the presence of specific serum antibodies (immunoglobulin-G class, present in all 11 patients) and/or viral RNA detection in serum and/or stools. Acute hepatitis lesions were observed in all cases with marked necro-inflammatory activity in nine patients. Confluent necrosis was present in five cases. Anisocaryosis and Kupffer's cell aggregates with siderosis were observed in most of the 11 patients. Cholangitis was frequent (9/11 cases). Cholestasis was observed in eight cases. Pseudo-glandular pattern was present in only one case but without zonal repartition. Characteristic pathological signs of acute hepatitis E were severe intralobular necrosis, polymorph inflammation, and acute cholangitis with numerous neutrophils.

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Section: Discussionmentioning

confidence: 99%

Liver histology in patients with sporadic acute hepatitis E: a study of 11 patients from South-West France

et al. 2007

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“…An elevated ALT level was observed in hepatitis viruses seropositive children in this study. Elevation of liver enzymes (especially ALT) is indicative of hepatocellular inflammation and necrosis and is considered to be a hallmark of HAV and HEV infection [Su et al, 2002]. Hepatitis B and C are common cause of elevated ALT results.…”

Section: Discussionmentioning

confidence: 99%

Seroepidemiology of hepatitis A, B, C, and E viruses infection among preschool children in Taiwan

Lin

Chen

et al. 2005

Journal of Medical Virology

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Taiwan was a hyperendemic area for hepatitis A and B viruses (HAV and HBV) infection before late 1980s. To study the seroprevalence of hepatitis A, B, C, and E viruses (HCV and HEV) infection among preschool children in Taiwan, a community‐based survey was carried out in 54 kindergartens in 10 urban areas, 10 rural areas, and 2 aboriginal areas randomly selected through stratified sampling. Serum specimens of 2,538 preschool children were screened for the hepatitis A, C, and E antibodies by a commercially available enzyme immunoassay and for HBV markers by radioimmunoassay methods. The multivariate‐adjusted odd ratios (OR) with their 95% confidence intervals (CI) were estimated through the multiple logistic regression analysis. Females had a statistically significantly higher HAV seroprevalence than males. The seroprevalence of HCV infection increased significantly with age. The larger the sibship size, the higher the seroprevalence of HBV infection. Aboriginal children had a significantly higher seroprevalence of HBV and HEV infection and lower seroprevalence of HCV infection than non‐aboriginal children. A significantly higher seroprevalence of HBV infection was found in rural children than urban children. There was no significant association between serostatus of HAV and HEV infection and between serostatus of HBV and HCV infection among preschool children in Taiwan. The poor environmental and hygienic conditions in the aboriginal areas might play a role in infection with HBV and HEV. J. Med. Virol. 78:18–23, 2006. © 2005 Wiley‐Liss, inc.

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“…There was no signifi cant difference in the amount of alcohol intake (>40 g/day) between the patients with AH-A and AH-E (3 cases, 21.4% in AH-A; and 2 cases, 20% in AH-E, respectively). The clinical disease forms of AH were divided into two groups: self-limiting AH and acute severe hepatitis without encephalopathy (ASH) based on the criteria for these diseases in Japan [24,[28][29][30][31]. The prevalence of these two forms was not signifi cantly different between the AH-A and AH-E patients (Table 4).…”

Section: Differences In Clinical Background and Laboratory Data Betwementioning

confidence: 99%

“…In typical AH patients with HAV or HEV infection, except for patients who progress to ALF or acute on chronic liver failure (AOC), histological fi ndings of the liver such as focal necrosis, infi ltration of lymphocytes and plasma cells into the portal area, and cholestasis are generally seen [13,[28][29][30][31][32]. These pathological changes may be affected by the following factors: 1) degree of liver damage; 2) duration from disease onset to observation of liver histology; and 3) area of the liver biopsy that is performed.…”

Section: Introductionmentioning

confidence: 99%

Hepatic histological comparison between Acute Self-limiting Hepatitis A and Hepatitis E

Suzuki¹,

Tatemichi²,

Yoshida³

et al. 2017

Arch Hepat Res

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Background: Histological fi ndings of the liver in acute liver injury are basically affected by degree of liver damage. However, the differences in liver histology between acute self-limiting hepatitis A (AH-A) and hepatitis E (AH-E) have not yet been clarifi ed. This study aimed to clarify the differences in histological fi ndings of the liver between AH-A and AH-E.Methods: Fourteen patients with AH-A and 11 patients with AH-E matched with the period between the onset of AH and the performance of liver biopsy and with the degree of liver function impairment were studied. The activity grade and fi brosis stage were evaluated using the METAVIR scoring system and the semiquantitative scores using 9 items from histological fi ndings: interface hepatitis, portal lymphocytes, portal neutrophils, lobular necrosis, lobular infl ammation, steatosis, ballooning, Mallory bodies, and cholestasis. Results:The patients with AH-E were signifi cantly older and had a higher proportion of males than the patients with AH-A. Although liver function test values and prothrombin time on admission signifi cantly differed between AH-A and AH-E, these values on the day of liver biopsy were not signifi cantly different between AH-A and AH-E. Among the histological scores studied, lobular necrosis score was signifi cantly higher in AH-A than in AH-E. Alcohol abuse did not affect the histological differences between AH-A and AH-E. Among the AH-E patients, activity grade, lobular necrosis, and lobular infl ammation scores were signifi cantly high in patients showing positive drug-induced lymphocyte stimulation tests. Conclusions:The lobular necrosis score among the histological fi ndings of the liver was signifi cantly higher in AH-A than in AH-E. Aging and immunoreaction against drugs might contribute to the histological changes in AH-E.

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Comparison of clinical manifestations and epidemiology between acute hepatitis A and acute hepatitis E in Taiwan

Abstract: Patients with AHE in Taiwan had older age of onset, more records of traveling history, and poorer clinical manifestations than those with AHA, and age seemed to be the most important factor to influence outcome.

Cited by 16 publications

References 27 publications

Liver histology in patients with sporadic acute hepatitis E: a study of 11 patients from South-West France

Liver histology in patients with sporadic acute hepatitis E: a study of 11 patients from South-West France

Seroepidemiology of hepatitis A, B, C, and E viruses infection among preschool children in Taiwan

Hepatic histological comparison between Acute Self-limiting Hepatitis A and Hepatitis E

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