Clinical Course and Outcome of Acute Hepatitis E Infection in Patients with Chronic Hepatitis B and C
Received Date: Jan 10, 2023 / Published Date: Jan 31, 2023
Abstract
Hepatitis E virus (HEV) is the most common cause of enteral non-A, non-B hepatitis. Alcohol abuse, concomitant liver diseases and immunosuppression are thought to increase the risk of contagion, severe illness, and development of chronic disease. HEV infection might take a severe course in those coinfected with other hepatotropic viruses.
Objectives: The aim of this paper is to present a retrospective analysis of the clinical course and outcome of acute hepatitis E infection in patients with confirmed chronic hepatitis B and C infection, who were treated at the Department of Infectious Diseases of Pazardzhik Multiprofile Hospital for Active Treatment, Pazardzhik, Bulgaria between 2013– 2017.
Materials and Methods: 25 patients, 22 males and 3 females, with acute hepatitis E infection and concomitant chronic hepatitis B and C infection. The methods used include epidemiological study, clinical observation, laboratory, and serological tests for detection of viral antigens and antibodies, and medical imaging (abdominal ultrasonography). The diagnosis of acute hepatitis E was established by the detection of specific anti-HEV IgM, IgG antibodies in significantly high values; chronic HBV and HCV infection was confirmed by the detection of viral antigens and specific antibodies.
Results: Chronic HBV infection was found in 18 of the patients (72%), 6/25 (24%) were with chronic hepatitis C, whereas only 1 (4%) had chronic HBV/HCV coinfection. 40% had cardiovascular disease and/or diabetes, 7 had cirrhosis. Alcohol abuse was reported by 7 patients. Complication due to acute on chronic liver failure was observed in 4 patients, 2 of whom died. The disease end in recovery in 23 patients.
Conclusion: People with pre-existing liver diseases, including chronic viral hepatitis, are at increased risk of severe hepatitis E and unfavorable outcome. Further studies among larger group that include people from risk groups and the general population would contribute to the better understanding of hepatitis E infection.
Citation: Kotsev S, Pishmisheva-Peleva M, Golkocheva-Markova E, Ismailova C, Vatev N (2023) Clinical Course and Outcome of Acute Hepatitis E Infection in Patients with Chronic Hepatitis B and C. J Clin Infect Dis Pract, 8: 171.
Copyright: © 2023 Kotsev S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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