Acute pancreatitis: A rare complication of acute hepatitis E

Deniel, Cécile; Coton, T; Brardjanian, S.; Guisset, M.; Nicand, Élisabeth; Simon, Fabrice

doi:10.1016/j.jcv.2011.04.009

Cited by 69 publications

(40 citation statements)

References 12 publications

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“…Acute pancreatitis has been associated with HEV1 infection (46)(47)(48)(49). However, no cases of pancreatitis have been reported with any of the other genotypes.…”

Section: Extrahepatic Manifestations Of Hevmentioning

confidence: 99%

Hepatitis E Virus Infection

et al. 2014

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SUMMARY Hepatitis E virus (HEV) infection is a worldwide disease. An improved understanding of the natural history of HEV infection has been achieved within the last decade. Several reservoirs and transmission modes have been identified. Hepatitis E is an underdiagnosed disease, in part due to the use of serological assays with low sensitivity. However, diagnostic tools, including nucleic acid-based tests, have been improved. The epidemiology and clinical features of hepatitis E differ between developing and developed countries. HEV infection is usually an acute self-limiting disease, but in developed countries it causes chronic infection with rapidly progressive cirrhosis in organ transplant recipients, patients with hematological malignancy requiring chemotherapy, and individuals with HIV. HEV also causes extrahepatic manifestations, including a number of neurological syndromes and renal injury. Acute infection usually requires no treatment, but chronic infection should be treated by reducing immunosuppression in transplant patients and/or the use of antiviral therapy. In this comprehensive review, we summarize the current knowledge about the virus itself, as well as the epidemiology, diagnostics, natural history, and management of HEV infection in developing and developed countries.

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“…Acute pancreatitis has been associated with HEV1 infection (46)(47)(48)(49). However, no cases of pancreatitis have been reported with any of the other genotypes.…”

Section: Extrahepatic Manifestations Of Hevmentioning

confidence: 99%

Hepatitis E Virus Infection

et al. 2014

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“…A range of extrahepatic manifestations have been described in association with HEV infection in European and Asian countries. These complications include neurological disorders (Kamar et al 2011;Cheung et al 2012;Santos et al 2013;van den Berg et al 2014;Woolson et al 2014), myasthenia gravis (Belbezier et al 2014), thrombocytopenia (Fourquet et al 2010), aplastic anemia (Shah et al 2012) glomerulonephritis (Kamar et al 2012) and acute pancreatitis (Deniel et al 2011). Among them, neurological complications are more frequently reported, including Guillain-Barré syndrome, brachial neuritis, transverse myelitis, cranial nerve palsy and peripheral neuropathy (Kamar et al 2011;Cheung et al 2012;van den Berg et al 2014;Woolson et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Characteristics of 20 Patients with Autochthonous Acute Hepatitis E in Hokkaido, Japan: First Report of Bilateral Facial Palsy Following the Infection with Genotype 4 Hepatitis E Virus

Yazaki

Sugawara²,

Honda

et al. 2015

Tohoku J. Exp. Med.

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Autochthonous hepatitis E is increasingly being recognized in industrialized countries, including Japan. Although neurological abnormalities have been sporadically reported as an extrahepatic manifestation of hepatitis E virus (HEV) infection, it is rare and has not been reported in Japan. The present study aimed to characterize a total of 20 patients consecutively diagnosed with sporadic acute hepatitis E at a city hospital in Hokkaido, Japan, during 2001-2014, focusing on a patient complicated with neuropathy. Seventeen patients were infected with genotype 4 HEV, while the remaining three patients were with genotype 3 HEV. Although a 67-year-old male with severe hepatitis did not have predisposing factors associated with the development of neurological disorders, such as diabetes mellitus and the use of immunosuppressive agents, he developed bilateral peripheral facial palsy six days after admission. A neurological examination revealed the inability to smile, frown, close his eyes completely or puff out his cheeks. MRI brain scans were considered to be normal. Although it took 83 days after admission for the total bilirubin levels to normalize, his neurological symptoms resolved gradually within three weeks without any sequelae following conservative therapy. A full-length genomic analysis of the HEV strain (HE-JA30) isolated from the patient belonged to genotype 4 and was closest to that currently circulating in Hokkaido, Japan. This is the first report of HEV-associated neuropathy in Japan. While all of previous reports on HEV-related neuropathy involve genotype 3 HEV, the present report is unique in that genotype 4 HEV is responsible for the neuropathy.

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“…Extrahepatic manifestations such as hematological manifestations (8)(9)(10), acute pancreatitis (11), kidney injuries (12), or neurological manifestations can also occur (13)(14)(15).…”

mentioning

confidence: 99%

Mutation in the Hepatitis E Virus Polymerase and Outcome of Ribavirin Therapy

Lhomme

Kamar

Nicot³

et al. 2016

Antimicrob Agents Chemother

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m Hepatitis E virus (HEV) can lead to chronic infection in solid-organ transplant patients. Ribavirin is efficient for treatment of chronically infected patients. Recently, the1634R mutation in the HEV polymerase has been associated with treatment failure. However, it is unclear if this mutation can be used as a prognostic marker of treatment outcome. We studied the prevalence of the 1634R mutation in the HEV polymerase of patients starting ribavirin therapy, the influence of the 1634R variants on the viral response, the frequency of the 1634R mutation in patients whose treatment failed, and its impact on ribavirin retreatment. We analyzed pretreatment samples from 63 solid-organ transplant patients with chronic hepatitis E using deep sequencing; 42 patients had a sustained virologic response (SVR), and 21 were non-SVR patients. We detected the 1634R variant by deep sequencing in 36.5% (23/63) of the patients (proportions, 1.3 to 100%). The 1634R variant was detected in 31.0% (13/42) of baseline plasma samples from patients with SVR and in 47.6% (10/21) in the other patients (P ‫؍‬ 0.2). The presence of this mutation did not influence the initial decrease in viral RNA. Lastly, a second prolonged ribavirin treatment led to SVR in 70% of the patients who initially did not have SVR, despite the presence of the 1634R variant. We conclude that the presence of the 1634R variant at ribavirin initiation does not lead to absolute ribavirin resistance. Although its proportion increased in patients whose treatment failed, the presence of the 1634R variant did not compromise the response to a second ribavirin treatment.

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Acute pancreatitis: A rare complication of acute hepatitis E

Cited by 69 publications

References 12 publications

Hepatitis E Virus Infection

Hepatitis E Virus Infection

Characteristics of 20 Patients with Autochthonous Acute Hepatitis E in Hokkaido, Japan: First Report of Bilateral Facial Palsy Following the Infection with Genotype 4 Hepatitis E Virus

Mutation in the Hepatitis E Virus Polymerase and Outcome of Ribavirin Therapy

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