Role of hepatitis E virus in sporadic cases of acute and fulminant hepatitis in an endemic area (Chad).

Coursaget, Pierre; Buisson, Y.; N'gawara, Mamouth Nahor; Cuyck-Gandre, H. Van; Roué, R.

doi:10.4269/ajtmh.1998.58.330

Cited by 52 publications

(40 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…16 HEV is predominantly transmitted through contaminated water and food. [1][2][3][4][5][6][7]14,15,[17][18][19][20][21] The disproportionate pregnancy rate among the women and girls with ALF in the current study may raise the suspicion of sexual transmission of HEV. However, sexual transmission of HEV has not been reported.…”

Section: Discussionmentioning

confidence: 99%

A 20-year single-center experience with acute liver failure during pregnancy: Is the prognosis really worse?

et al. 2008

View full text Add to dashboard Cite

Pregnant patients with acute liver failure (ALF) are believed to have a worse outcome than nonpregnant women and men with ALF. However objective data supporting this supposition are scant. Therefore, the current study compared the outcome, complications, and causes of ALF among pregnant women and girls with age-matched nonpregnant women and girls and men and boys with ALF. One thousand fifteen consecutive ALF patients in the reproductive age group, admitted at the All India Institute of Medical Sciences, New Delhi, from January 1986 to December 2006, were included in the study. A total of 249 (38.5%) women were pregnant. They were compared with 341 nonpregnant women and girls and 425 men and boys, aged 15 to 45 years. The mortality rate of pregnant women and girls (53.8%) was similar to age-matched nonpregnant women and girls (57.2%), and men and boys (57.9%); P ‫؍‬ 0.572.The clinical and biochemical features, disease severity, and complications were also similar in the three groups. A significantly higher proportion of ALF was attributable to hepatitis E virus (HEV) among women and girls who were pregnant (59.4%), as compared with both nonpregnant women and girls (30.4%), and men and boys (23.1%); P < 0.001. However, the outcome of HEV-related ALF was independent of the sex and pregnancy status of the patients (P ‫؍‬ 0.103). Mortality in HEV-ALF and non-HEV-ALF patients in pregnant women and girls was 51% (74/145) and 54.7% (52/ 95)(P > 0.1), respectively. The outcome of pregnant ALF patients was also unrelated to the trimester of pregnancy. The mortality of non-HEV-related ALF among the pregnant women and girls (54.7%), age-matched nonpregnant women and girls (61.7%), and men and boys (62.8%) were also similar (P > 0.1). Conclusion: The mortality of pregnant patients with ALF is similar to that of nonpregnant women and girls and men and boys and is independent of the cause or trimester. Pregnancy per se should not be regarded as a poor prognostic factor for a patient with ALF. (HEPATOLOGY 2008;48:1577-1585

show abstract

Section: Discussionmentioning

confidence: 99%

A 20-year single-center experience with acute liver failure during pregnancy: Is the prognosis really worse?

et al. 2008

View full text Add to dashboard Cite

show abstract

“…29 Possibly analogous increased severity of hepatitis A and B has been ascribed to pregnancy-related depression of cell-mediated immunity. 31 Coursaget and others 11 speculate that the superimposition of acute HEV on chronic liver disease caused by HBV may lead to acute or fulminant hepatitis in some patients, including pregnant women. In Chad, these authors found that of 35 patients with sporadic acute or fulminant hepatitis E, 21 (60%) and 5 (14%) had sero-logical evidence of, respectively, chronic and acute hepatitis B.…”

Section: Discussionmentioning

confidence: 99%

“…Hepatitis B virus surface antigen was present in 30% of controls. 11 Hepatitis B virus infection is hyperendemic in Kavango; a 1983 study demonstrated that 98% of the population showed some serological evidence of exposure, with a 13.6% carriage rate of HBV surface antigen. 28 Our small sample (Table 2) showed no significant difference (P ϭ 0.81, Fisher's exact test) between patients with overt hepatitis and normal controls with regard to HBV surface antigen carriage, but a much larger study would be required to investigate any association.…”

Section: Discussionmentioning

confidence: 99%

“…30 More recent reports of hepatitis E have emerged from many other African countries. [3][4][5][6][7][8][9][10][11] In southern Africa, surveys in South Africans and in Mozambican refugees living in Swaziland have shown serologic evidence of HEV infection, [35][36][37] but no actual disease has been documented by detection of HEV in clinical specimens. This report of hepatitis E in southern Africa is the first to unambiguously document cases by detection of HEV in patient specimens.…”

Section: Discussionmentioning

confidence: 99%

“…1 In the past decade, hepatitis E has been shown to be the cause of sporadic and epidemic hepatitis across central and south Asia, 2 and in northern and subSaharan Africa. [3][4][5][6][7][8][9][10][11] One of the largest outbreaks of hepatitis E, in Delhi, India (1955) was identified retrospectively by identification of antibodies to HEV in archived serum specimens. 12 Polymerase chain reaction (PCR) tests to detect HEV RNA 8,13,14 and improved serology for HEV [15][16][17][18] have greatly increased the ability of reference laboratories to identify hepatitis E disease.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

An outbreak of hepatitis E in Northern Namibia, 1983.

Isaäcson

Frean²,

He³

et al. 2000

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. In 1983 in Namibia's Kavango region, epidemic jaundice affected hundreds of people living in settlements lacking potable water and waste disposal facilities. Many were Angolan refugees. The disease, which after investigation was designated non-A non-B hepatitis, was most common in males (72%), in persons aged 15-39 years, and was usually mild except in pregnant women, who incurred 6 (86%) of the 7 fatal infections. Fifteen years later, archived outbreak-associated samples were analyzed. Hepatitis E virus (HEV) was detected by reverse transcriptionpolymerase chain reaction in feces from 9 of 16 patients tested. Total Ig and IgM to HEV were quantitated in serum from 24 residents of an affected settlement at the outbreak's end: 42% had IgM diagnostic of recent infection and 25% had elevated total Ig without IgM, consistent with past HEV infection. The Namibia outbreak was typical hepatitis E clinically and epidemiologically. This first report of hepatitis E confirmed by virus detection from southern Africa extends the known range of HEV and highlights its risk for refugees.

show abstract

Analysis of the full-length genome of genotype 4 hepatitis E virus isolates from patients with fulminant or acute self-limited hepatitis E

et al. 2006

View full text Add to dashboard Cite

It was suggested that hepatitis E virus (HEV) genotype 4 is associated more closely with the severity of hepatitis E than genotype 3, although the virological basis remains unknown. The aim of this study was to examine whether genomic differences among genotype 4 HEVs are responsible for the development of fulminant hepatitis. Full-length sequences of genotype 4 HEVs from three patients with fulminant hepatitis and six patients with acute self-limited hepatitis were determined. The sequences were analyzed with those of 13 genotype 4 HEV isolates whose entire nucleotide sequence is known. Analysis of 22 full-length sequences (fulminant hepatitis, 5; acute hepatitis, 17) revealed that C at nt 1816 and U at nt 3148 (U3148), both of which do not change the amino acid sequences, were significantly associated with fulminant hepatitis (P = 0.0489, respectively). When partial nucleotide sequences containing nt 1816 or nt 3148 were determined in 16 additional HEV isolates of genotype 4, a closer association between U3148 and fulminant hepatitis (P = 0.0018) was observed. The comparison of 86 HEV isolates of all four genotypes showed that U3148 had a stronger association with fulminant hepatitis than other nucleotides at nt 3148 (P = 0.0006). Patients infected with HEV with U3148 had a significantly lower value of the lowest prothrombin activity (P = 0.0293). Nt 3148 is located within the RNA helicase domain, and 22-nt sequence including nt 3148 was well conserved among all genotypes. A silent substitution of U3148 in HEV may be associated with the development of fulminant hepatitis. Further studies are needed to clarify the underlying mechanism.

show abstract

Role of hepatitis E virus in sporadic cases of acute and fulminant hepatitis in an endemic area (Chad).

Cited by 52 publications

References 27 publications

A 20-year single-center experience with acute liver failure during pregnancy: Is the prognosis really worse?

A 20-year single-center experience with acute liver failure during pregnancy: Is the prognosis really worse?

An outbreak of hepatitis E in Northern Namibia, 1983.

Analysis of the full-length genome of genotype 4 hepatitis E virus isolates from patients with fulminant or acute self-limited hepatitis E

Contact Info

Product

Resources

About