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Hepatitis E infection is an under recognized cause of acute decompensation in patients with chronic liver disease.

Abstract

BACKGROUND/AIMS
We aimed to assess characteristics of patients with a positive hepatitis E virus serology with emphasis on acute on chronic liver disease.
METHODS
This was a retrospective audit performed at a large teaching hospital.
RESULTS
Of the 164 patients tested, 15(9.1%) had a positive serology (hepatitis E virus IgG and or IgM) of whom two also had a positive hepatitis E virus RNA. Six (42.8%) had underlying chronic liver disease and presented with deteriorating liver tests±decompensation. In one patient (16%) acute hepatitis E virus infection was the aetiology for the decompensation and in three the positive hepatitis E virus IgG was a reflection of prior subclinical infection. However, in two of the six patients with unexplained decompensation there was delay (150-270 days) in obtaining a hepatitis E virus serology, which may have resulted in a negative hepatitis E virus IgM at time of testing.
CONCLUSIONS
9.1% of patients presenting with abnormal liver tests at a large teaching hospital in south east England have a positive hepatitis E virus serology of whom 42.8% have acute on chronic liver disease. In 16% hepatitis E virus infection is the aetiology for the acute decompensation. This may be an under representation as in >30% of patients with unexplained decompensation there is considerable delay in requesting a hepatitis E virus serology.

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  • Publisher Full Text
  • Authors

    De Silva S, Hassan-Ibrahim MO, Austin M, Newport M, Verma S

    Institution

    Department of Gastroenterology, Brighton and Sussex University Hospitals, Brighton, UK.

    Source

    Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 44:11 2012 Nov pg 930-4

    MeSH

    Acute Disease
    Adult
    Aged
    Chronic Disease
    Disease Progression
    Fatty Liver
    Female
    Hepatitis E
    Humans
    Liver Cirrhosis
    Liver Diseases
    Male
    Middle Aged
    Retrospective Studies

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22592074