Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study.

Abstract:

BACKGROUND:In developed countries, hepatitis E is a porcine zoonosis caused by hepatitis E virus (HEV) genotype 3. In developing countries, hepatitis E is mainly caused by genotype 1, and causes increased mortality in patients with pre-existing chronic liver disease (CLD). AIM:To determine the role of HEV in patients with decompensated CLD. METHODS:Prospective HEV testing of 343 patients with decompensated CLD at three UK centres and Toulouse France, with follow-up for 6 months or death. IgG seroprevalence was compared with 911 controls. RESULTS:11/343 patients (3.2%) had acute hepatitis E infection, and three died. There were no differences in mortality (27% vs. 26%, OR 1.1, 95% CI 0.28-4.1), age (P = 0.9), bilirubin (P = 0.5), alanine aminotransferase (P = 0.06) albumin (P = 0.5) or international normalised ratio (P = 0.6) in patients with and without hepatitis E infection. Five cases were polymerase chain reaction (PCR) positive (genotype 3). Hepatitis E was more common in Toulouse (7.9%) compared to the UK cohort (1.2%, P = 0.003). HEV IgG seroprevalence was higher in Toulouse (OR 17, 95% CI 9.2-30) and Truro (OR 2.5, 95% CI 1.4-4.6) than in Glasgow, but lower in cases, compared to controls (OR 0.59, 95% CI 0.41-0.86). CONCLUSIONS:Hepatitis E occurs in a minority of patients with decompensated chronic liver disease. The mortality is no different to the mortality in patients without hepatitis E infection. The diagnosis can only be established by a combination of serology and PCR, the yield and utility of which vary by geographical location.

journal_name

Aliment Pharmacol Ther

authors

Blasco-Perrin H,Madden RG,Stanley A,Crossan C,Hunter JG,Vine L,Lane K,Devooght-Johnson N,Mclaughlin C,Petrik J,Stableforth B,Hussaini H,Phillips M,Mansuy JM,Forrest E,Izopet J,Blatchford O,Scobie L,Peron JM,Dalton H

doi

10.1111/apt.13309

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

574-81

issue

5

eissn

0269-2813

issn

1365-2036

journal_volume

42

pub_type

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