Low mortality despite temporary liver dysfunction in severe courses of acute hepatitis E.
Wien Klin Wochenschr
; 135(3-4): 57-66, 2023 Feb.
Article
in En
| MEDLINE
| ID: mdl-36547761
ABSTRACT
BACKGROUND:
Hepatitis E virus (HEV) infection can cause severe viral hepatitis and eventually liver failure. We aim to provide novel data on the epidemiology and the course of HEV infections from Q1/2008 to Q3/2018â¯at the Vienna General Hospital.METHODS:
Of the 88,945 people tested, we identified HEV-IgM positive (+) or HEV-PCR (+) patients and retrospectively collated information on the course of infection from patient records.RESULTS:
Among 151 HEV-IgM or PCR (+) (median age 51 years, 45.8% female), 7 (4.6%) had non-severe acute HEV infection (ALT ≥â¯2-5-fold upper limit of normal, ULN), 11 (7.3%) had severe HEV infection without liver dysfunction (LD) (ALT >â¯5-fold ULN), and 9 (6.0%) with LD (ikterus or bilirubin >â¯5â¯mg/dL, OR coagulopathy or INR >â¯1.5, OR encephalopathy or ammonia >â¯100⯵mol/L). HEV-RNA-PCR was performed in 58/190 (30.5%) HEV-IgM (+) patients and was positive in 19 (30.6%). Rates of HEV IgM/PCR positivity remained stable over the observation period. The HEV genotype (GT) was GT1 in 71.4% (nâ¯= 5) and GT3 in 28.6% (nâ¯= 2). Travel history was recorded for 9/20 (45.0%) of severe HEV and 12/20 (60.0%) patients with severe HEV infection were hospitalized. One patient with pre-existing liver disease and concomitant EBV infection required intensive care. No patient required transplantation and the 30-day mortality was 3/151 (1.9%). Despite the increased testing rates, the absolute number of diagnosed HEV infections at Vienna General Hospital remained constant between 2008 to 2018.CONCLUSION:
Although approximately half of the patients with severe acute HEV infection required hospitalization, admissions to the intensive care unit (ICU) and short-term mortality were low.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Hepatitis E virus
/
Hepatitis E
Type of study:
Prognostic_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Wien Klin Wochenschr
Year:
2023
Document type:
Article
Affiliation country:
Austria