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

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• 作者：Sampath De Silva ; Mohammed Osman Hassan-Ibrahim ; Mark Austin ; Melanie Newport ; Sumita Verma
• 关键词：Acute hepatitis ; Acute on chronic liver disease ; Hepatitis E virus
• 刊名：Digestive and Liver Disease
• 出版年：2012
• 出版时间：November, 2012
• 年：2012
• 卷：44
• 期：11
• 页码：930-934
• 全文大小：194 K

文摘

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 ¡À 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.