2019
DOI: 10.1007/s00508-019-01547-2
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Acute liver failure in immunocompetent patients infected with hepatitis E

Abstract: SummaryIn almost all immunocompetent patients an acute hepatitis E virus (HEV) infection is clinically silent with spontaneous viral clearance. So far, only a very small number of severe acute HEV infections have been described. This article reports the case of a 78-year-old immunocompetent, diabetic patient, who presented with a symptomatic acute HEV genotype (GT) 3 infection and that progressed to acute liver failure. After starting with an antiviral therapy with ribavirin, the HEV viral load rapidly decreas… Show more

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Cited by 9 publications
(9 citation statements)
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“…A histopathological study of HEV infection has also been conducted in gerbils, which showed lymphocyte and eosinophil infiltration and histiocytic hepatitis [42]. In humans, portal inflammation and interface hepatitis are observed in acute HEV patients [43,44]. However, fibrosis is increased in patients with chronic HEV infection [44,45].…”
Section: Discussionmentioning
confidence: 99%
“…A histopathological study of HEV infection has also been conducted in gerbils, which showed lymphocyte and eosinophil infiltration and histiocytic hepatitis [42]. In humans, portal inflammation and interface hepatitis are observed in acute HEV patients [43,44]. However, fibrosis is increased in patients with chronic HEV infection [44,45].…”
Section: Discussionmentioning
confidence: 99%
“…Most immunocompetent patients infected with hepatitis E clear the infection spontaneously, and progression to acute liver failure is rare. However, HEV3 tends to cause more severe disease in older men and patients with diabetes [35], and acute liver failure has been reported in these patients [36]. It has been suggested that subclinical hepatic steatosis/fibrosis may underlie the more severe presentations seen in this group [37].…”
Section: Clinical Presentationmentioning
confidence: 99%
“…The patient was receiving metformin, but without excessive dosage history. Wenter et al reported the case of a 78-year-old immunocompetent diabetes patient, who presented with symptomatic infection by a genotype 3 virus and progressed to acute liver insufficiency [ 8 ]. Ribavirin treatment rapidly lowered the HEV RNA load and led to complete resolution of acute fulminant hepatitis E. Gynthersen et al reported the case of a 50-year-old type 2 diabetic, alcoholic patient admitted for jaundice, fever, and a painful abdomen and who developed meningoencephalitis symptoms [ 9 ].…”
Section: Discussionmentioning
confidence: 99%