Lower Levels of Transaminases but Higher Levels of Serum Creatinine in Patients with Acute Hepatitis E in Comparison to Patients with Hepatitis A

Brehm, Thomas Theo; Mazaheri, Omid; Horvatits, Thomas; Lütgehetmann, Marc; Wiesch, Julian Schulze zur; Lohse, Ansgar W.; Polywka, Susanne; Pischke, Sven

doi:10.3390/pathogens10010060

Cited by 12 publications

(16 citation statements)

References 19 publications

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“…It has previously been shown that renal function is slightly deteriorated in the setting of acute HEV genotype 3 infection [6]. Furthermore, a complex interplay of immune cells and renal epithelium with acute kidney injury in HEV genotype 1 infections has been shown [12].…”

Section: Discussionmentioning

confidence: 99%

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Lack of Evidence for an Association between Previous HEV Genotype-3 Exposure and Glomerulonephritis in General

et al. 2021

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Among numerous other immune-mediated diseases, glomerulonephritis has also been suspected to be an extrahepatic manifestation of HEV infection. In this prospective study, we tested 108 patients with glomerulonephritis and 108 age- and sex-matched healthy controls at the University Hospital Hamburg Eppendorf, Hamburg, Germany, for anti-HEV IgG (Wantai test) as a marker for previous HEV exposure. A total of 24 patients (22%) tested positive for anti-HEV IgG. Males tended to be more frequently anti-HEV IgG positive (29%) in comparison to females (16%). However, this does not reach statistical significance (p = 0.07). Anti-HEV IgG positive patients were older in comparison to negative patients (mean 53 vs. 45 years, p = 0.05). The kidney function seems to be slightly decreased in anti-HEV IgG positive patients in comparison to and anti-HEV IgG negative patients basing on creatinine (p = 0.04) and glomerular filtration rate (GFR) (p = 0.05). Slightly higher values of bilirubin could be found in IgG positive patients (p = 0.04). Anti-HEV-IgG seropositivity rate (22%) in glomerulonephritis patients, did not differ significantly in comparison to an age- and sex-matched control cohort of healthy blood donors (31/108 positive, 29%). A total of 2/2 patients with membranoproliferative glomerulonephritis (MPGN) tested anti-HEV IgG positive (p = 0.002 in comparison to glomerulonephritis patients with other subtypes).In conclusion, our findings indicate that previous HEV exposure in a region where GT3 is endemic is not associated with glomerulonephritis in general. However, the subgroup of MPGN patients should be investigated in future studies. Furthermore, future studies are needed to investigate whether the observed association between anti-HEV IgG positivity and reduced GFR in glomerulonephritis patients is HEV associated or is an age-related effect.

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Section: Discussionmentioning

confidence: 99%

“…Large cohort studies investigating an association between HEV infections and renal diseases are still lacking. However, recently it has been described that patients with HEV infections have a reduced kidney function in comparison to patients with hepatitis A virus infections [6].…”

Section: Introductionmentioning

confidence: 99%

Lack of Evidence for an Association between Previous HEV Genotype-3 Exposure and Glomerulonephritis in General

et al. 2021

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“…HEV infection has been associated with immune-mediated kidney diseases [ 86 ] even in immunocompetent patients [ 87 ], and AKI occurred in 8.6% in a cohort study [ 88 ]. Renal disease in acute HEV infection cases was slightly worse than in HAV infection cases [ 89 ]. HEV genotype 1, and HEV genotype 3 especially, have been strongly associated with renal disease [ 83 , 90 ].…”

Section: Hepatitis Virusesmentioning

confidence: 99%

Virus-Associated Nephropathies: A Narrative Review

Masset

Turnier

Bressollette-Bodin

et al. 2022

IJMS

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While most viral infections cause mild symptoms and a spontaneous favorable resolution, some can lead to severe or protracted manifestations, specifically in immunocompromised hosts. Kidney injuries related to viral infections may have multiple causes related to the infection severity, drug toxicity or direct or indirect viral-associated nephropathy. We review here the described virus-associated nephropathies in order to guide diagnosis strategies and treatments in cases of acute kidney injury (AKI) occurring concomitantly with a viral infection. The occurrence of virus-associated nephropathy depends on multiple factors: the local epidemiology of the virus, its ability to infect renal cells and the patient’s underlying immune response, which varies with the state of immunosuppression. Clear comprehension of pathophysiological mechanisms associated with a summary of described direct and indirect injuries should help physicians to diagnose and treat viral associated nephropathies.

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“…Metabolites of the virus may invade the wall of the gallbladder or biliary epithelial cells, leading to cholestasis, which in turn results in acalculous cholecystitis (10,25). The extrahepatic manifestations of HE reported to date mainly include acute pancreatitis (26), neurological diseases (27,28), kidney injury (29), and hematologic disorders (30,31). HE-related cholecystitis was not reported in a study from Qatar until 2009; however, there were only two cases (32).…”

Section: Introductionmentioning

confidence: 99%

Acalculous cholecystitis is a common extrahepatic manifestation of hepatitis E and suggests a more serious condition

Cao

Jiang

Shi

et al. 2023

Preprint

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Background: This study aimed to understand the incidence and clinical significance of acalculous cholecystitis in patients with acute hepatitis E (HE). Patients and methods: A single center enrolled 114 patients with acute HE. All patients underwent imaging of the gallbladder, and patients with gallstones and cholecystectomy were excluded. Results: Acalculous cholecystitis was found in 66 patients (57.89%) with acute HE. The incidence in males was 63.95%, which was significantly higher than in females (39.29%) (P=0.022). The mean length of hospital stay and the incidence of spontaneous peritonitis in patients with cholecystitis (20.12 ± 9.43 days and 9.09%, respectively) were significantly higher than those in patients without cholecystitis (12.98 ± 7.26 days and 0%, respectively) (P<0.001 and P=0.032). Albumin , total bile acid, bilirubin, cholinesterase, and prothrombin activity in patients with cholecystitis were significantly inferior to those in patients without cholecystitis (P<0.001, P<0.001, P<0.001, P<0.001 and P= 0.003, respectively). After correction by multivariate analysis, albumin and total bile acid were found to be closely related to acalculous cholecystitis in HE. Conclusion: Acalculous cholecystitis is very common in patients with acute HE, and may serve as a predictor of increased peritonitis, synthetic decompensation, and longer hospital stay.

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Lower Levels of Transaminases but Higher Levels of Serum Creatinine in Patients with Acute Hepatitis E in Comparison to Patients with Hepatitis A

Cited by 12 publications

References 19 publications

Lack of Evidence for an Association between Previous HEV Genotype-3 Exposure and Glomerulonephritis in General

Lack of Evidence for an Association between Previous HEV Genotype-3 Exposure and Glomerulonephritis in General

Virus-Associated Nephropathies: A Narrative Review

Acalculous cholecystitis is a common extrahepatic manifestation of hepatitis E and suggests a more serious condition

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