Blasco-Perrin, H. et al. (2015) Hepatitis e virus in patients with decompensated chronic liver disease: a prospective UK/French study. Alimentary Pharmacology and Therapeutics, 42(5), pp. 574-581. (doi: 10.1111/apt.13309) (PMID:26174470)
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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.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Stanley, Dr Adrian and Forrest, Dr Ewan and Blatchford, Dr Oli |
| 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., and Dalton, H.R. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
| Journal Name: | Alimentary Pharmacology and Therapeutics |
| Publisher: | Wiley |
| ISSN: | 0269-2813 |
| ISSN (Online): | 1365-2036 |
| Published Online: | 14 July 2015 |
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