Hepatitis E Virus and rheumatic diseases: what do rheumatologists need to know?

Bartolomeo, Salvatore Di; Carubbi, Francesco; Cipriani, Paola

doi:10.1186/s41927-020-00149-0

Cited by 11 publications

(5 citation statements)

References 68 publications

(146 reference statements)

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“…AIH is an uncommon cause of chronic liver disease and viral infections are known to trigger AIH [ 5 ]. Different viral and bacterial infections are known to trigger autoimmunity [ 6 , 7 ]. They are associated with different various rheumatological diseases [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Hepatitis E Virus Infection Triggering Autoimmune Hepatitis in a Patient With Chronic Liver Disease: Case Report and the Review of the Literature

Malakar,

Shah,

Mishra

et al. 2024

Cureus

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Acute viral hepatitis E (HEV) is the most common form of acute viral hepatitis in India. It is associated with self-limiting disease in most cases. However, the chronic form of HEV is also being increasingly recognized. Other viral infections like the hepatitis A virus (HAV) have been implicated in inciting autoimmune hepatitis. HEV infection has been associated with the formation of circulating liver-directed autoantibodies, however autoimmune liver disease following acute HEV infection has been rarely reported. Here we present a case of a 72-year-old diabetic lady who presented to us with an asymptomatic rise of liver enzymes. Investigations suggested metabolic dysfunction associated with steatotic liver disease. After three months of the diagnosis, she developed acute-on-chronic liver failure and her anti-HEV came out positive. She was managed accordingly. Afterwards patient had persistent high liver enzymes, so she underwent a liver biopsy. Her liver biopsy was compatible with autoimmune hepatitis.

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Section: Discussionmentioning

confidence: 99%

Acute Hepatitis E Virus Infection Triggering Autoimmune Hepatitis in a Patient With Chronic Liver Disease: Case Report and the Review of the Literature

Malakar,

Shah,

Mishra

et al. 2024

Cureus

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“…This may explain why chronic HEV infection is rare in patients with HIV, who typically experience a progressive loss of CD4 T cells in isolation. Patients with cancer receiving chemotherapy and/or immunotherapy [ 48 ], as well as those with autoimmune diseases (e.g., rheumatic diseases) receiving immunosuppressive or immunomodulatory therapies [ 49 ], are also at risk of developing CHE.…”

Section: Chronic Hepatitis E (Che)mentioning

confidence: 99%

The Diagnosis, Pathophysiology, and Treatment of Chronic Hepatitis E Virus Infection—A Condition Affecting Immunocompromised Patients

Takakusagi¹,

Kakizaki

Takagi³

2023

Microorganisms

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Hepatitis E is a zoonosis caused by hepatitis E virus (HEV), which was first discovered 40 years ago. Twenty million HEV infections worldwide are estimated each year. Most hepatitis E cases are self-limiting acute hepatitis, but the virus has been recognized to cause chronic hepatitis. Following the first case report of chronic hepatitis E (CHE) in a transplant recipient, CHE has recently been identified as associated with chronic liver damage induced by HEV genotypes 3, 4, and 7—usually in immunocompromised patients such as transplant recipients. In addition, patients infected with HIV and those receiving chemotherapy for malignancy, along with patients with rheumatic disease and COVID-19, have recently been reported as having CHE. CHE can be easily misdiagnosed by usual diagnostic methods of antibody response, such as anti-HEV IgM or IgA, because of the low antibody response in the immunosuppressive condition. HEV RNA should be evaluated in these patients, and appropriate treatments—such as ribavirin—should be given to prevent progression to liver cirrhosis or liver failure. While still rare, cases of CHE in immunocompetent patients have been reported, and care must be taken not to overlook these instances. Herein, we conduct an overview of hepatitis E, including recent research developments and management of CHE, in order to improve our understanding of such cases. The early diagnosis and treatment of CHE should be performed to decrease instances of hepatitis-virus-related deaths around the world.

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“…8 Patients with cancer receiving chemotherapy and/or immunotherapy, 9 and patients with autoimmune diseases (e.g. rheumatic diseases) receiving immunosuppressive or immunomodulatory therapies 10 are also at risk of developing chronic hepatitis E.…”

Section: Epidemiology In Immunocompromised Populationsmentioning

confidence: 99%