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

De Silva, S, Hassan Ibrahim, MO, Austin, M, Newport, Melanie and Verma, Sumita (2012) Hepatitis E infection is an under recognized cause of acute decompensation in patients with chronic liver disease. Digestive and Liver Disease, 44 (11). pp. 930-934. ISSN 1590-8658

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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.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Clinical and Experimental Medicine
Brighton and Sussex Medical School > Global Health and Infection
Subjects: R Medicine > RC Internal medicine > RC0109 Infectious and parasitic diseases
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Depositing User: Ellen Thomas
Date Deposited: 06 Mar 2013 15:28
Last Modified: 21 Sep 2017 11:44
URI: http://sro.sussex.ac.uk/id/eprint/41054
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