Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study. Issue 5 (14th July 2015)

• Record Type: Journal Article
• Authors: Blasco‐Perrin, H.; Madden, R. G.; Stanley, A.; Crossan, C.; Hunter, J. G.; Vine, L.; Lane, K.; Devooght‐Johnson, N.; Mclaughlin, C.; Petrik, J.; Stableforth, B.; Hussaini, H.; Phillips, M.; Mansuy, J. M.; Forrest, E.; Izopet, J.; Blatchford, O.; Scobie, L.; Peron, J. M.; Dalton, H. R.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 42:Issue 5(2015)
• Page Start: 574
• Page End: 581
• Publication Date: 2015-07-14
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.13309
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" id="apt13309-abs-0001"> <title>Summary</title> <sec id="apt13309-sec-0001" sec-type="section"> <title>Background</title> <p>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).</p> </sec> <sec id="apt13309-sec-0002" sec-type="section"> <title>Aim</title> <p>To determine the role of HEV in patients with decompensated CLD.</p> </sec> <sec id="apt13309-sec-0003" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="apt13309-sec-0004" sec-type="section"> <title>Results</title> <p>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 (<italic>P</italic> = 0.9), bilirubin (<italic>P</italic> = 0.5), alanine aminotransferase (<italic>P</italic> = 0.06) albumin (<italic>P</italic> = 0.5) or international normalised ratio (<italic>P</italic> = 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%, <italic>P</italic> = 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).</p> </sec> <sec id="apt13309-sec-0005" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>