Acute hepatitis E in Montenegro: Epidemiology, clinical and laboratory features

Epidemiological characteristics and clinical manifestations of hepatitis E virus infection in Bulgaria: A report on 20 patients

“…This is the result of the ever improving knowledge on HEV infection as well as the progress in modern diagnostic methods. The cases presented in this report are sporadic and autochthonous such as other non-travel related hepatitis E cases reported previously in the Netherlands, Germany, England and Wales, France, Italy, Serbia, Montenegro, Greece, Romania and Hungary [13,14,[16][17][18][19][20][21][22][23][24]. In this study, as in the previously reported cases, the male sex was more affected than the female sex, the mean age was 51 years [21,25].…”

“…The cases presented in this report are sporadic and autochthonous such as other non-travel related hepatitis E cases reported previously in the Netherlands, Germany, England and Wales, France, Italy, Serbia, Montenegro, Greece, Romania and Hungary [13,14,[16][17][18][19][20][21][22][23][24]. In this study, as in the previously reported cases, the male sex was more affected than the female sex, the mean age was 51 years [21,25]. Unlike in endemic areas, where HEV infection showed no age prevalence, a higher prevalence was seen among older patients in non-endemic regions [13,14,16,18,20,21].…”

Hepatitis E virus infections in humans and animals

“…HEV can cause jaundice, vomiting, appetite loss, fatigue, hepatalgia, and hepatomegaly [16,17]. Increases in liver enzymes such as alanine aminotransferase, aspartate transaminase, and gamma-glutamyl transpeptidase are also common [17,18]. HEV is typically diagnosed by detection of viral RNA in serum or fecal samples and testing for anti-HEV IgM or IgG antibodies in the patient sera [16].…”

Clinically silent forms may partly explain the rarity of acute cases of autochthonous genotype 3c hepatitis E infection in France

“…However, the criteria adopted in the latter study were not sufficiently rigorous, since asymptomatic patients were defined as patients without symptoms and/or jaundice, whereas the diagnosis of HEV was based on IgM anti-HEV positivity without any HEV RNA testing. 10 The discrepancy between the high rate of HEV IgG seroprevalence and the low rate of clinically established acute hepatitis E probably means that asymptomatic HEV infection is common in industrialized countries, and/or that acute hepatitis E infection fails to be recognized or is insufficiently sought for, and/or that IgG seropositivity is non-specific and reflects cross-reacting antibodies. 11 HEV genotype 3 the predominant genotype in industrialized countries, consequently of high incidence of HEV subtype 3f.…”