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Hepatitis A and E in the Mediterranean: A systematic review. Travel Med Infect Dis 2022; 47:102283. [DOI: 10.1016/j.tmaid.2022.102283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/05/2022] [Accepted: 02/23/2022] [Indexed: 11/23/2022]
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Meta-Analysis of Human IgG anti-HEV Seroprevalence in Industrialized Countries and a Review of Literature. Viruses 2019; 11:v11010084. [PMID: 30669517 PMCID: PMC6357031 DOI: 10.3390/v11010084] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 01/16/2019] [Accepted: 01/18/2019] [Indexed: 12/11/2022] Open
Abstract
Although Hepatitis E is increasingly described as a major cause of liver disease in industrialized countries, the epidemiology is far from being fully elucidated. We provide here a comprehensive review of documented clusters of cases, and of serological studies conducted in populations with distinct types of exposure. Seroprevalence rates range from <5% to >50% depending on the countries and the groups of population. Such discrepancies can be attributed to the type of serological assay used, but this solves only a part of the problem. We performed a meta-analysis of studies performed with the broadly used Wantai HEV-IgG ELISA and found striking differences that remain difficult to understand with the current knowledge of transmission pathways.
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Tenorio González E, Robles Díaz M, Sanjuan Jiménez R, González Grande R, Olmedo Martín RV, Rodrigo López JM, Jiménez Pérez M. Retransplant Due to Fulminant Hepatic Failure From Hepatitis E Virus: A Case Report. Transplant Proc 2018; 50:685-686. [PMID: 29579889 DOI: 10.1016/j.transproceed.2017.09.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 09/22/2017] [Indexed: 01/15/2023]
Abstract
Hepatitis E virus (HEV) usually causes self-limiting acute liver infections from fecal or oral transmission, though other routes of infection exist (vertical transmission, blood transfusion, zoonosis). It may give rise to fulminant hepatic failure in 1% of cases. Cases have recently been reported of chronic infection evolving to cirrhosis in immunosuppressed patients, such as those with a liver or kidney transplant. Nonetheless, development of acute liver failure in these patients is exceptional, with few cases published. We present a case of acute liver failure due to HEV in a liver transplant patient who required a liver retransplant 9 years after receiving the original transplant.
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Affiliation(s)
| | - M Robles Díaz
- UGC Aparato Digestivo y Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Málaga, Spain
| | - R Sanjuan Jiménez
- UGC Aparato Digestivo y Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Málaga, Spain
| | | | | | | | - M Jiménez Pérez
- UGC Aparato Digestivo, Regional University Hospital, Malaga, Spain
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Monteserín Ron L, Jiménez Palacios M, Linares Torres P, Miguel Peña A, Álvarez Cuenllas B, Fernández-Natal MI, Valverde Romero E, Jorquera Plaza F. Autochthonous acute hepatitis E: an increasingly frequent diagnosis. Clinical-epidemiological analysis of our experience. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2018; 109:344-349. [PMID: 28376624 DOI: 10.17235/reed.2017.4258/2016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND In Europe, acute hepatitis caused by the hepatitis E virus (HEV) traditionally was an infection found in people who had travelled to endemic zones, mainly Asia and Africa. However, a growing number of sporadic autochthonous cases are now being diagnosed in the Western world. OBJECTIVE To analyze the cases of acute HEV hepatitis diagnosed in our setting, with the identification of the clinical-epidemiological characteristics. MATERIAL AND METHODS We included the cases of acute HEV hepatitis diagnosed (positive anti-HEV IgM and/or HEV RNA present in serum) between January 2008 and December 2014. Different clinical, epidemiological and evolutive parameters were analyzed. RESULTS A total of 23 patients were identified, all originating from Spain. Fourteen cases (60.87%) presented jaundice and marked cytolysis at the time of diagnosis (aspartate aminotransferase [AST] 1,106.91 U/l and alanine aminotransferase [ALT] 1,407.04 U/l). Twenty-two cases were regarded as autochthonous, and one patient had travelled to China three months before. The mean time to resolution was 11.2 weeks. Some autoimmune markers were positive in 43.5% of the patients. Two subjects were diagnosed with previous chronic liver disease and were classified as "acute-on-chronic liver failure" (ACLF), one died and the other underwent liver transplantation. CONCLUSION Acute HEV hepatitis in our setting is an autochthonous condition that is probably underdiagnosed, manifesting with jaundice and cytolysis. Autoimmune marker positivity is an epiphenomenon, which in some cases complicates the diagnosis.
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de Zárraga Mata C, Escudero Roldán M, Thomas Salom G, Rull Murillo N, Dolz Abadía C. Acute hepatitis due to hepatitis E virus after raw meat consumption. GASTROENTEROLOGIA Y HEPATOLOGIA 2017; 40:395-396. [PMID: 27496809 DOI: 10.1016/j.gastrohep.2016.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 06/26/2016] [Accepted: 06/28/2016] [Indexed: 06/06/2023]
Affiliation(s)
| | - María Escudero Roldán
- Servicio de Aparato Digestivo, Hospital Son Llàtzer, Palma de Mallorca, Baleares, España
| | - Guiem Thomas Salom
- Servicio de Aparato Digestivo, Hospital Son Llàtzer, Palma de Mallorca, Baleares, España
| | - Nuria Rull Murillo
- Servicio de Aparato Digestivo, Hospital Son Llàtzer, Palma de Mallorca, Baleares, España
| | - Carlos Dolz Abadía
- Servicio de Aparato Digestivo, Hospital Son Llàtzer, Palma de Mallorca, Baleares, España
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Mora Soler AM, Velasco-Guardado A, Martín Arribas MI, Acosta Materan R, Revilla Morato C, Pérez Corte D, Rodríguez Pérez A. [Chronic hepatitis caused by hepatitis E virus and treated with ribavirin]. GASTROENTEROLOGIA Y HEPATOLOGIA 2016; 39:597-598. [PMID: 26589539 DOI: 10.1016/j.gastrohep.2015.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 09/21/2015] [Accepted: 09/25/2015] [Indexed: 11/24/2022]
Affiliation(s)
- Ana María Mora Soler
- Servicio de Aparato Digestivo, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Salamanca, España.
| | - Antonio Velasco-Guardado
- Servicio de Aparato Digestivo, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Salamanca, España
| | - María Isabel Martín Arribas
- Servicio de Aparato Digestivo, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Salamanca, España
| | - Rosa Acosta Materan
- Servicio de Aparato Digestivo, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Salamanca, España
| | - Cristina Revilla Morato
- Servicio de Aparato Digestivo, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Salamanca, España
| | - Daniel Pérez Corte
- Servicio de Aparato Digestivo, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Salamanca, España
| | - Antonio Rodríguez Pérez
- Servicio de Aparato Digestivo, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Salamanca, España
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Singh MP, Majumdar M, Goyal K, Lakshmi P, Bhatia D, Ratho R. Investigation of suspected viral hepatitis outbreaks in North West India. Diagn Microbiol Infect Dis 2016; 84:309-14. [DOI: 10.1016/j.diagmicrobio.2015.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 12/08/2015] [Accepted: 12/09/2015] [Indexed: 11/15/2022]
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Lens S, Mensa L, Gambato M, González P, Torras X, Soriano G, Costa J, Capón A, Londoño MC, Mariño Z, Navasa M, Pérez-del-Pulgar S, Forns X. HEV infection in two referral centers in Spain; epidemiology and clinical outcomes. J Clin Virol 2015; 63:76-80. [DOI: 10.1016/j.jcv.2014.12.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 12/19/2014] [Accepted: 12/24/2014] [Indexed: 01/30/2023]
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Merchante N, Parra-Sánchez M, Rivero-Juárez A, Cifuentes C, Camacho Á, Macías J, Martínez-Dueñas L, Pérez-Navarro E, Rivero A, Pineda JA. High prevalence of antibodies against hepatitis E virus in HIV-infected patients with unexplained liver disease. Enferm Infecc Microbiol Clin 2014; 33:532-5. [PMID: 25533742 DOI: 10.1016/j.eimc.2014.10.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 09/24/2014] [Accepted: 10/17/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To look for evidence of hepatitis E virus (HEV) exposure in HIV-infected patients with unexplained elevations of liver stiffness (LS). METHODS Case-control study conducted in 31 HIV-infected patients with unexplained elevations of LS and in 31 HIV-controls with normal LS, matched by age, sex and CD4 cell-counts. Serum HEV antibodies were tested by two ELISA procedures and by Immunoblot. We defined exposure to HEV as the detection of serum HEV antibodies by at least one of the two ELISA assays, provided that it was confirmed by Immunoblot. A real-time PCR RNA assay was conducted in all plasma samples to identify subjects with active HEV infection. RESULTS Exposure to HEV was demonstrated, according to the criteria used in this study, in 9 (29%) of the cases, whereas it was shown in 5 (16%) of the controls (p=.3). Serum HEV RNA was detected in none of the controls and in only in one case. This patient had a documented chronic hepatitis E with progression to cirrhosis. CONCLUSIONS HEV antibodies are frequently found in HIV-infected patients with unexplained liver disease.
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Affiliation(s)
- Nicolás Merchante
- Unidad de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Sevilla, Spain
| | - Manuel Parra-Sánchez
- Unidad de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Sevilla, Spain
| | - Antonio Rivero-Juárez
- Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Celia Cifuentes
- Unidad de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Sevilla, Spain
| | - Ángela Camacho
- Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Juan Macías
- Unidad de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Sevilla, Spain
| | - Loreto Martínez-Dueñas
- Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Elisabet Pérez-Navarro
- Unidad de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Sevilla, Spain
| | - Antonio Rivero
- Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Juan A Pineda
- Unidad de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Sevilla, Spain.
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Aniţă A, Gorgan L, Aniţă D, Oşlobanu L, Pavio N, Savuţa G. Evidence of hepatitis E infection in swine and humans in the East Region of Romania. Int J Infect Dis 2014; 29:232-7. [PMID: 25447729 DOI: 10.1016/j.ijid.2014.10.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 08/29/2014] [Accepted: 10/02/2014] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Swine hepatitis E virus (HEV) is considered to be a new zoonotic agent due to its close genomic resemblance to the human HEV. The aim of this study was to determine human HEV seroprevalence in eastern Romania and to characterize circulating swine HEV sequences. METHODS Serological investigations of human serum samples were done using a commercial ELISA kit (MP Biomedicals). Swine faecal samples were tested to detect the HEV ORF2 sequence by nested reverse transcription PCR. RESULTS One hundred and forty-eight human serum samples were tested for anti-HEV IgG of which 22 were found to be positive. Fresh swine faeces (pools) were collected from five farms in eastern Romania. Six out of 19 pooled samples were positive for HEV RNA. Phylogenetic analysis based on alignment of the ORF2 sequence indicated that the Romanian swine HEV isolates belonged to genotype 3. CONCLUSIONS This is the first study showing HEV to be present in Romanian pig herds and that the human population is exposed.
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Affiliation(s)
- Adriana Aniţă
- Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 8 Mihail Sadoveanu Alley, 700489 Iaşi, Romania
| | - Lucian Gorgan
- Faculty of Biology, Alexandru Ioan Cuza University, Iaşi, Romania
| | - Dragoş Aniţă
- Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 8 Mihail Sadoveanu Alley, 700489 Iaşi, Romania
| | - Luanda Oşlobanu
- Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 8 Mihail Sadoveanu Alley, 700489 Iaşi, Romania
| | - Nicole Pavio
- UMR 1161 Virology, Anses, Animal Health Laboratory, Maisons-Alfort, France
| | - Gheorghe Savuţa
- Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 8 Mihail Sadoveanu Alley, 700489 Iaşi, Romania.
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Mateos-Lindemann ML, Diez-Aguilar M, González-Galdamez A, Graus-Morales J, Moreno-Zamora A, Perez-Gracia MT. [Acute, chronic and fulminant hepatitisE: seven years of experience (2004-2011)]. Enferm Infecc Microbiol Clin 2013; 31:595-8. [PMID: 23642282 DOI: 10.1016/j.eimc.2013.03.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 02/18/2013] [Accepted: 03/08/2013] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To study the clinical and epidemiological profiles of in 43cases of acute hepatitis, 5cases of fulminant hepatitis, and one of chronic hepatitis due to hepatitis E virus (HEV), detected over a 7-year period. PATIENTS Forty-nine individuals (33male and 10female) treated between 2004 and 2011 in the Hospital Ramón y Cajal (Comunidad de Madrid, Spain). The diagnosis was made by the detection of IgG and IgM anti-HEV and RNA HEV in serum samples. Acute hepatitisE was defined by the presence of IgM anti-HEV and/or RNA HEV in serum, and chronic hepatitisE if the ARN was detectable more than 6months. Fulminant hepatitisE was diagnosed if encephalopathy was observed in addition to IgM anti-HEV and/or RNA HEV in serum. RESULTS The median age was 46.67 and 49.6years in acute hepatitisE and fulminant hepatitisE, respectively. The risk factors recorded were travel to endemic areas in 13patients, 4were in contact with animals, 4suffered from hepatic steatosis due to alcohol consumption, 3consumed uncontrolled foods, and 2drank water from streams. DISCUSSION HEV is the cause of acute self-limited hepatitis, although 36.73% of the studied cases had to be hospitalised. However a small number of patients, 10.2%, had fulminant hepatitis requiring liver transplant. Chronic hepatitisE is very infrequent in immunocompetent individuals. The increase in incidence of hepatitisE is due to the introduction of better diagnostic tests in recent years.
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