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Autochthonous hepatitis E in Southwest England: natural history, complications and seasonal variation, and hepatitis E virus IgG seroprevalence in blood donors, the elderly and patients with chronic liver disease.
Eur J Gastroenterol Hepatol. 2008 Aug; 20(8):784-90.EJ

Abstract

AIMS

To report the natural history of autochthonous hepatitis E and hepatitis E virus (HEV) IgG seroprevalence in Southwest England.

METHODS

Patients with unexplained hepatitis were tested for hepatitis E and cases followed until recovery or death. Five hundred blood donors, 336 individuals over the age of 60 years and 126 patients with chronic liver disease were tested for HEV IgG.

RESULTS

Forty cases of autochthonous hepatitis E (genotype 3) were identified. Hepatitis E was anicteric in 25% of cases and usually caused a self-limiting hepatitis predominantly in elderly Caucasian males. Six of 40 had a significant complication and three patients died, two of who had previously undiagnosed cirrhosis. Hepatitis E shows a seasonal variation with peaks in the spring and summer and no cases in November and December. HEV IgG prevalence increases with age, is more common in men and is 16% in blood donors, 13% in patients with chronic liver disease and 25% in individuals over 60 years.

CONCLUSION

Autochthonous hepatitis E is more common than previously recognized, and should be considered in the differential diagnosis in patients with hepatitis, whatever their age or travel history. It carries a significant morbidity and when seen in the context of chronic liver disease carries an adverse prognosis.

Authors+Show Affiliations

Cornwall Gastrointestinal Unit, Royal Cornwall Hospital Trust, Truro, Cornwall, UK. harry.dalton@rcht.cornwall.nhs.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18617784

Citation

Dalton, Harry R., et al. "Autochthonous Hepatitis E in Southwest England: Natural History, Complications and Seasonal Variation, and Hepatitis E Virus IgG Seroprevalence in Blood Donors, the Elderly and Patients With Chronic Liver Disease." European Journal of Gastroenterology & Hepatology, vol. 20, no. 8, 2008, pp. 784-90.
Dalton HR, Stableforth W, Thurairajah P, et al. Autochthonous hepatitis E in Southwest England: natural history, complications and seasonal variation, and hepatitis E virus IgG seroprevalence in blood donors, the elderly and patients with chronic liver disease. Eur J Gastroenterol Hepatol. 2008;20(8):784-90.
Dalton, H. R., Stableforth, W., Thurairajah, P., Hazeldine, S., Remnarace, R., Usama, W., Farrington, L., Hamad, N., Sieberhagen, C., Ellis, V., Mitchell, J., Hussaini, S. H., Banks, M., Ijaz, S., & Bendall, R. P. (2008). Autochthonous hepatitis E in Southwest England: natural history, complications and seasonal variation, and hepatitis E virus IgG seroprevalence in blood donors, the elderly and patients with chronic liver disease. European Journal of Gastroenterology & Hepatology, 20(8), 784-90. https://doi.org/10.1097/MEG.0b013e3282f5195a
Dalton HR, et al. Autochthonous Hepatitis E in Southwest England: Natural History, Complications and Seasonal Variation, and Hepatitis E Virus IgG Seroprevalence in Blood Donors, the Elderly and Patients With Chronic Liver Disease. Eur J Gastroenterol Hepatol. 2008;20(8):784-90. PubMed PMID: 18617784.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Autochthonous hepatitis E in Southwest England: natural history, complications and seasonal variation, and hepatitis E virus IgG seroprevalence in blood donors, the elderly and patients with chronic liver disease. AU - Dalton,Harry R, AU - Stableforth,William, AU - Thurairajah,Prem, AU - Hazeldine,Simon, AU - Remnarace,Rene, AU - Usama,Warshow, AU - Farrington,Liz, AU - Hamad,Noor, AU - Sieberhagen,Cyril, AU - Ellis,Vic, AU - Mitchell,Jonathan, AU - Hussaini,S Hyder, AU - Banks,Malcolm, AU - Ijaz,Samreen, AU - Bendall,Richard P, PY - 2008/7/12/pubmed PY - 2008/10/2/medline PY - 2008/7/12/entrez SP - 784 EP - 90 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 20 IS - 8 N2 - AIMS: To report the natural history of autochthonous hepatitis E and hepatitis E virus (HEV) IgG seroprevalence in Southwest England. METHODS: Patients with unexplained hepatitis were tested for hepatitis E and cases followed until recovery or death. Five hundred blood donors, 336 individuals over the age of 60 years and 126 patients with chronic liver disease were tested for HEV IgG. RESULTS: Forty cases of autochthonous hepatitis E (genotype 3) were identified. Hepatitis E was anicteric in 25% of cases and usually caused a self-limiting hepatitis predominantly in elderly Caucasian males. Six of 40 had a significant complication and three patients died, two of who had previously undiagnosed cirrhosis. Hepatitis E shows a seasonal variation with peaks in the spring and summer and no cases in November and December. HEV IgG prevalence increases with age, is more common in men and is 16% in blood donors, 13% in patients with chronic liver disease and 25% in individuals over 60 years. CONCLUSION: Autochthonous hepatitis E is more common than previously recognized, and should be considered in the differential diagnosis in patients with hepatitis, whatever their age or travel history. It carries a significant morbidity and when seen in the context of chronic liver disease carries an adverse prognosis. SN - 0954-691X UR - https://www.unboundmedicine.com/medline/citation/18617784/Autochthonous_hepatitis_E_in_Southwest_England:_natural_history_complications_and_seasonal_variation_and_hepatitis_E_virus_IgG_seroprevalence_in_blood_donors_the_elderly_and_patients_with_chronic_liver_disease_ L2 - https://doi.org/10.1097/MEG.0b013e3282f5195a DB - PRIME DP - Unbound Medicine ER -