Posts filed under ‘Hepatitis E’

EASL Clinical Practice Guidelines on hepatitis E virus infection. European Association for the Study of the Liver.

J Hepatol. 2018 Jun;68(6):1256-1271


Infection with hepatitis E virus (HEV) is a significant cause of morbidity and mortality, representing an important global health problem.

Our understanding of HEV has changed completely over the past decade. Previously, HEV was thought to be limited to certain developing countries.

We now know that HEV is endemic in most high-income countries and is largely a zoonotic infection.

Given the paradigm shift in our understanding of zoonotic HEV and that locally acquired HEV is now the commonest cause of acute viral hepatitis in many European countries, the focus of these Clinical Practice Guidelines will be on HEV genotype 3 (and 4).



March 21, 2019 at 8:27 am

Seroprevalence and risk factors of Hepatitis E infection in Jordan’s population: First report

International Journal of Infectious Diseases January 2018 V.66 P.121–125

Mohammad M. Obaidat, Amira A. Roess


  • Seroprevalce, risk factors and zoonotic potential of HEV were studied.
  • HEV antibodies occurs at high prevalence (30.9%) overall in Jordan.
  • HEV infection associates with age and eating undercooked meat.
  • Owning camels increased the odds of HEV seropositivity.


Hepatitis E virus (HEV) is hyperendemic in many countries, but data on this virus are not available in Jordan. This study determined the seroprevalence, risk factors and zoonotic potential of HEV in a Jordanian population.


A total of 450 sera samples from 8 different governorates were tested for HEV-IgG. A pre-tested and validated questionnaire was used to collect risk factor data including animal interaction and environmental exposures.


The overall seroprevalence was 30.9%. Eating undercooked meat was significantly associated with HEV seropositivity (OR = 2.06, 95%CI 1.04–4.06) after controlling for age, gender, travel history and source of water. Age was also associated with HEV seropositivity; the youngest (≤14 years of age) and oldest age groups (60 and 80 years of age) had the highest prevalence (45.5% and 53.2%, respectively), compared to those between 20 to 29 years of age and 30 to 39 years of age (20.2 and 15.2%, respectively), although the small sample size among the youngest group tempers this association. There was evidence of a marginal association between owning camels and an increased odds of HEV seropositivity. Place of residence and source of drinking water were not associated with infection.


This is the first study to report HEV seroprevalence in Jordan and shows that HEV exposure is high in Jordan. Surveillance for acute and chronic Hepatitis E is needed to estimate the frequency of the actual disease.



February 10, 2018 at 9:14 am

Hepatitis E virus infection as a promoting factor for hepatocellular carcinoma in Cameroon: Preliminary Observations

International Journal of Infectious Diseases November 2017 V.64 N. P.4–8

Marie Amougou Atsama, Paul Jean Adrien Atangana, Dominique Noah Noah, Paul Fewou Moundipa, Pascal Pineau, Richard Njouom



To determine the seroprevalence of hepatitis E virus (HEV) infection in patients with chronic hepatitis and/or hepatocellular carcinoma (HCC) and to assess its potential consequences for disease progression.


We conducted a prospective case-control study on patients with HCC hepatitis B or C related and non-HCC patients including patients with CLD and patients without clinical evidence of liver disease. Anti-HEV IgG and IgM were tested by ELISA using commercially available kits. Liver damage was assessed by alanine aminotransferase, aspartate aminotransferase, platelets and prothrombin measurements.


We observed a significant anti-HEV IgG carriage in HCC patients compared to non-HCC subjects with CLD (41.8% vs 12.6%; P = 9.1 E-6; OR = 4.8, 95%CI: 2.3-10.6). HCC patients with HEV infection display more profound alterations of circulating liver enzymes, platelets count and prothrombin time than HCC patients without sero-reactivity to HEV.


Overall, this study indicates a high prevalence of HEV infection in Cameroonian patients with CLD and HCC. These data suggest either that patients with liver tumors are more susceptible to hepeviral infection or that, in a tropical context, HEV might promote the progression of liver diseases towards tumor.



February 9, 2018 at 1:17 pm

Revisiones – Diagnóstico microbiológico de las hepatitis virales

Enf Infecc & Microbiol. Clínica Noviembre 2015 V.33 N.9 e53-e62

Roberto Alonso, Antonio Aguilera, Juan Córdoba, Antonio Fuertes

a Servicio de Microbiología y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, España

b Servicio de Microbiología, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, España

c Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, Valencia, España

d LABCO QualityDiagnostics, Madrid, España

La inflamación hepática o hepatitis tiene causas diversas, tanto infecciosas como no infecciosas. Entre las primeras, cabe destacar la etiología viral que es la causa de, al menos, la mitad de todas las hepatitis en el mundo.

Se han descrito distintos virus con tropismo primario por el tejido hepático. Estos microorganismos se han ido nombrando sucesivamente con las letras del abecedario: A, B, C, D, E y G.

El objetivo de este artículo es revisar este grupo heterogéneo de virus en sus aspectos más básicos, sus implicaciones clínicas, su tratamiento, las principales medidas preventivas frente a estas infecciones y, con especial interés, las aproximaciones diagnósticas, tanto serológicas como moleculares, que se utilizan para su detección, cuantificación y caracterización


February 20, 2017 at 3:26 pm

Pregnancy and susceptibility to infectious diseases.

Infect Dis Obstet Gynecol. 2013;2013:752852.

Sappenfield E1, Jamieson DJ, Kourtis AP.

Author information

1Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.


To summarize the literature regarding susceptibility of pregnant women to infectious diseases and severity of resulting disease, we conducted a review using a PubMed search and other strategies. Studies were included if they reported information on infection risk or disease outcome in pregnant women.

In all, 1454 abstracts were reviewed, and a total of 85 studies were included. Data were extracted regarding number of cases in pregnant women, rates of infection, risk factors for disease severity or complications, and maternal outcomes.

The evidence indicates that pregnancy is associated with increased severity of some infectious diseases, such as influenza, malaria, hepatitis E, and herpes simplex virus (HSV) infection (risk for dissemination/hepatitis); there is also some evidence for increased severity of measles and smallpox.

Disease severity seems higher with advanced pregnancy. Pregnant women may be more susceptible to acquisition of malaria, HIV infection, and listeriosis, although the evidence is limited. These results reinforce the importance of infection prevention as well as of early identification and treatment of suspected influenza, malaria, hepatitis E, and HSV disease during pregnancy.


August 15, 2015 at 5:29 pm

Hepatitis E virus: a zoonosis adapting to humans

Antimicrob. Chemother. (2010) 65(5): 817-821


November 21, 2014 at 8:44 am

Outbreak of Hepatitis E in Urban Bangladesh Resulting in Maternal and Perinatal Mortality

Clinical Infectious Diseases September 1, 2014 V.59 N.5 P.658-665

Emily S. Gurley1, M. Jahangir Hossain1, Repon C. Paul1, Hossain M. S. Sazzad1, M. Saiful Islam1, Shahana Parveen1, Labib I. Faruque1, Mushtuq Husain2, Khorshed Ara2, Yasmin Jahan2, Mahmudur Rahman2, and Stephen P. Luby1,3

1icddr,b (International Center for Diarrhoeal Disease Research, Bangladesh)

2 Ministry of Health and Family Welfare, Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh

3Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia

Correspondence: Emily S. Gurley, MPH, PhD, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh (


Hepatitis E virus (HEV) causes outbreaks of jaundice associated with maternal mortality. Four deaths among pregnant women with jaundice occurred in an urban community near Dhaka, Bangladesh, in late 2008 and were reported to authorities in January 2009. We investigated the etiology and risk factors for jaundice and death.


Field workers identified suspected cases, defined as acute onset of yellow eyes or skin, through house-to-house visits. A subset of persons with suspected HEV was tested for immunoglobulin M (IgM) antibodies to HEV to confirm infection. We used logistic regression analysis to identify risk factors for HEV disease and for death. We estimated the increased risk of perinatal mortality associated with jaundice during pregnancy.


We identified 4751 suspected HEV cases during August 2008–January 2009, including 17 deaths. IgM antibodies to HEV were identified in 56 of 73 (77%) case-patients tested who were neighbors of the case-patients who died. HEV disease was significantly associated with drinking municipally supplied water. Death among persons with HEV disease was significantly associated with being female and taking paracetamol (acetaminophen). Among women who were pregnant, miscarriage and perinatal mortality was 2.7 times higher (95% confidence interval, 1.2–6.1) in pregnancies complicated by jaundice.


This outbreak of HEV was likely caused by sewage contamination of the municipal water system. Longer-term efforts to improve access to safe water and license HEV vaccines are needed. However, securing resources and support for intervention will rely on convincing data about the endemic burden of HEV disease, particularly its role in maternal and perinatal mortality.



October 15, 2014 at 8:23 am

Crossing Borders: One World, Global Health

Clinical Infectious Diseases July 1, 2014 V.59 N.1

Clive M. Brown and Martin S. Cetron, Section Editors

Rotavirus Enteritis in Dadaab Refugee Camps: Implications for Immunization Programs in Kenya and Resettlement Countries

Maurice Ope, Steve B. Ochieng, Collins Tabu, Nina Marano.

Dadaab refugee camp, established in Kenya in 1991, is host to >500 000 refugees, most of whom are Somali in origin. Annually, the United States resettles approximately 11 000 refugees from Africa, 4000 of them from Kenya. Although substantial progress has been made to provide safe water and improve sanitation in Dadaab, diarrheal disease remains among the leading causes of morbidity and mortality. Several disease outbreaks, including hepatitis E virus, cholera, and wild poliovirus, have been attributed to poor sanitation in the camps.

Rotavirus enteritis is an acute viral infection that is transmitted by the fecal–oral route and affects nonimmune people, particularly children <5 years old. Rotavirus causes severe diarrhea in young children, particularly in developing countries, and contributes to high childhood mortality. Rotavirus infects nearly every child by the age of 3–5 years. Severe rotavirus enteritis is, however, preventable through vaccination early in life.

To date, 53 countries have implemented routine vaccination against rotavirus, including 12 in Africa (Botswana, Burkina Faso, Burundi, Ethiopia, The Gambia, Ghana, Malawi, Mali, Rwanda, South Africa, Tanzania, and Zambia). The role …


June 29, 2014 at 7:34 pm

Hepatitis E Virus Genotype 4 Outbreak, Italy, 2011

Emerg Infect Diseases January 2013 V.19 N.1 P.110-114

Anna R. Garbuglia, Paola Scognamiglio, Nicola Petrosillo, Claudio Maria Mastroianni, Pasquale Sordillo, Daniele Gentile, Patrizia La Scala, Enrico Girardi, and Maria R. Capobianchi

Lazzaro Spallanzani National Institute for Infectious Diseases, Rome, Italy (A.R. Garbuglia, P. Scognamiglio, N. Petrosillo, P. La Scala, E. Girardi, M.R. Capobianchi); Sapienza University, Rome (C.M. Mastroianni); Santa Maria Goretti Hospital, Latina, Italy (C.M. Mastroianni); Tor Vergata University Polyclinic, Rome (P. Sordillo); and Local Health Unit ASL Roma H, Rome (D. Gentile)

During 2011, 5 persons in the area of Lazio, Italy were infected with a monophyletic strain of hepatitis E virus that showed high sequence homology with isolates from swine in China. Detection of this genotype in Italy parallels findings in other countries in Europe, signaling the possible spread of strains new to Western countries.


December 22, 2012 at 1:45 pm

Hepatitis E – virología molecular, epidemiología y patogénesis

Enf Infecc & Microbio. Clínica Dic. 2012

Francisco Rodríguez-Frias a,c, Rosendo Jardi a,c y María Buti b,c

a Unidad de Proteínas Hepatitis, Servicio de Bioquímica, Hospital Universitario Vall d’Hebron, Barcelona, Espana˜

b Unidad de Hepatología, Hospital Universitario Vall d’Hebron, Barcelona, Espana˜

c CIBERehd, Instituto Carlos III, Espana

La hepatitis E representa una proporción significativa de las enfermedades hepáticas de transmisión entérica y constituye un importante problema de salud pública, especialmente en los países en vías de desarrollo, principalmente asociada a epidemias debidas a la contaminación de los suministros de agua. El virus de la hepatitis E (VHE) es responsable de infecciones hepáticas agudas autolimitadas de transmisión oral-fecal. En países industrializados la hepatitis E aguda es esporádica, detectada en viajeros procedentes de zonas endémicas pero también en casos esporádicos sin factores de riesgo. El VHE es un virus sin envuelta con genoma de ARN de cadena sencilla en el que se han caracterizado 4 genotipos con un único serotipo. Los genotipos 1 y 2 son los predominantes en los países en desarrollo y tan solo infectan a seres humanos, mientras que los 3 y 4, que predominan en los países industrializados, también infectan a otras especies de mamíferos, especialmente el cerdo, y múltiples evidencias clasifican al VHE como un agente zoonótico. Recientemente se han comunicado casos de infección crónica por este virus en pacientes trasplantados hepáticos y renales. La tasa de mortalidad de la infección por VHE es mayor que la de la hepatitis A. Además de la vía oral-fecal se han comunicado transmisiones parenterales de este virus. Diversas vacunas se hallan actualmente en desarrollo. La severidad de esta infección en algunos grupos de pacientes, especialmente en embarazadas, y la presencia de casos de hepatitis crónica incluso con progresión a cirrosis han suscitado el interés por la aplicación de terapias antivirales con interferón y/o ribavirina …





December 13, 2012 at 2:56 pm

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