Locally acquired hepatitis E in chronic liver disease

Hepatitis E infection is usually a self-limiting disease. In industrialized countries, sporadic cases of acute hepatitis E virus (HEV) infections have been described; their number seems to be increasing in European countries. We report the first human case of autochthonous acute hepatitis E confirmed in Portugal. Patients with acute non-A-C hepatitis should be tested for HEV in Portugal and hepatitis E infection should be considered in the differential diagnosis of unexplained hepatitis cases.

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“…The outcome can be poor in individuals with underlying chronic liver disease, with mortality close to 70% [4,5].…”

Section: Discussionmentioning

confidence: 99%

First report of acute autochthonous hepatitis E in Portugal

Duque

Ventura

Seixas

et al. 2011

J Infect Dev Ctries

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“…# Confirmation by immunoblot/Western blot. $ Report includes other study type of EL1 - [31] is also reported in Table 3 and [49] in Table 2. · Significant result from logistic regression.…”

Section: Potential For Zoonotic Transmission By Direct Animal Contactmentioning

confidence: 99%

Transmission routes and risk factors for autochthonous hepatitis E virus infection in Europe: a systematic review

2009

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SUMMARYIncreasing numbers of non-travel-associated hepatitis E virus (HEV) infections have been reported in Europe in recent years. Our objective was to review the evidence on risk factors and transmission routes of autochthonous HEV infection and hepatitis E in Europe in order to develop recommendations for future research, prevention and control. A systematic literature review was performed to identify all primary reports and studies published during 1998-2008 on hepatitis E in humans and animals in Europe by searching Pubmed, reference lists of major articles and international conference proceedings. Each of the 106 included studies was categorized into one of three evidence levels (EL) based on study design and diagnostic methodology. The evidence was generally weak (73 were assigned to EL1, two to both EL1 and EL2, and 30 to EL2), further compounded by the use of poorly validated serological assays in some studies. Only one casecontrol study was assigned to EL3. Persons with autochthonous hepatitis E infection were on average older than the general population and predominantly male. There was no evidence for one main transmission route of HEV infection or risk factor for hepatitis E. However, zoonotic transmission seemed likely and person-to-person transmission too inefficient to cause clinical disease. Multiple routes of transmission probably exist and should be further investigated through analytical studies and reliable diagnostic kits. Based on current evidence that points to zoonotic transmission from pigs, thorough cooking of all porcine products, prevention of crosscontamination in the kitchen and improved education for occupationally exposed people (e.g. pig farmers, veterinarians and sewage workers) may help prevent HEV infection. Although evidence for parenteral transmission is limited, it is recommended that a risk assessment is undertaken.

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“…Moreover, there is increasing evidence that autochthonous transmission might account for a substantial proportion of these cases, and that hepatitis E is a zoonosis in swine, which might be a source of contamination to humans (10). Although hepatitis E is typically self-limiting, fulminant hepatitis E and associated deaths have been reported from various places, including Europe (5,8). Mortality rates of 0.1 to 2% have been reported, being ca.…”

Section: Case Reportmentioning

confidence: 99%

Severe Thrombocytopenia Associated with Acute Hepatitis E Virus Infection

et al. 2008

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We describe here what is, to the best of our knowledge, the third reported case of severe thrombocytopenia associated with acute hepatitis E virus infection. The patient was a 72-year-old French woman. It seems likely that the cause of the thrombocytopenia was acute hepatitis E virus infection, possibly occurring via an immune mechanism. No complications were noted, in contrast to the two previous reports.

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Locally acquired hepatitis E in chronic liver disease

Cited by 134 publications

References 3 publications

First report of acute autochthonous hepatitis E in Portugal

First report of acute autochthonous hepatitis E in Portugal

Transmission routes and risk factors for autochthonous hepatitis E virus infection in Europe: a systematic review

Severe Thrombocytopenia Associated with Acute Hepatitis E Virus Infection

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