Comparing the Clinical Features and Outcomes of Acute Hepatitis E Viral Infections with Those of Acute Hepatitis A, B, and C Infections in Korea

Abstract

Objectives: This study investigated the etiology of acute viral hepatitis and compared the clinical features of hepatitis E virus (HEV) infections with those of other acute viral hepatitis infections in Korea. Methods: This study included 2,357 consecutive patients who were diagnosed with acute hepatitis, based on acute illness with jaundice or elevated alanine aminotransferase levels (>100 IU/L), between January 2007 and January 2016. Acute viral infections were observed in 23 (19.8%) patients with HEV, 49 (42.2%) patients with hepatitis A virus, 28 (24.1%) patients with hepatitis B virus, and 16 (13.8%) patients with hepatitis C virus. Results: The incidence of acute HEV infection was higher among older patients (median age: 49 years) and male patients (69.6%), and was associated with the consumption of undercooked or uncooked meat (43.5%). Half of the acute HEV infections involved underlying liver disease, such as alcoholic liver disease, chronic hepatitis B, common bile duct stones, and autoimmune hepatitis. Two HEV-infected patients were diagnosed with Guillain-Barré syndrome, although no patients developed fulminant hepatitis. Conclusion: Our findings indicate that HEV infection in Korea is frequently transmitted through the consumption of raw meat and may cause acute or chronic liver disease.

Prevalence and clinical correlation of hepatitis E virus antibody in the patients’ serum samples from a tertiary care hospital in Thailand during 2015–2018

“…A study in Korea indicated that the median peak AST and ALT levels of patients with HEV infection were similar to those infected with HCV but lower than those infected with HAV and HBV. In contrast, the median peak total bilirubin levels in patients with HEV infections were similar to those infected with HAV and HBV but higher than those infected with HCV [ 36 ]. However, our study did not design to compare the liver function test among the four hepatitis viruses as the serum samples were recruited from patients initially suspected of HEV infection.…”

Seroprevalence and risk factors of hepatitis B, C and D virus infection amongst patients with features of hepatitis in a referral hospital in Botswana: A cross-sectional study

“…22 This is higher than the seroprevalence reported in studies from patients with liver disease in India (25.9%), Mongolia (29.2%), Sudan (30%) and Ethiopia (35.8%). 9,10,12,25 Studies amongst patients with chronic liver disease with smaller sample sizes have reported higher prevalence of 54.2% -61.4% from Ghana and India. 13,26,27 The presence of at least one serological marker of HBV infection in this study population (81.4%) agrees with reports from this region, where 70% -95% of adults have serological evidence of past exposure to this infection.…”

Current Paradigm of Hepatitis E Virus Among Pediatric and Adult Patients

“…Hemolytic anemia was reported in 23% of patients with acute E hepatitis as a complication of acute infection ( 134 ). During viral infection, patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency have lower level of glutathione, which leads to accumulation of oxidants and results in hemolysis during acute HEV infection ( 135 , 136 ). Only a few cases of autoimmune hemolytic anemia were described in patients with HEV, on the basis on clinical manifestation, hypersplenism, and positive direct antiglobulin test ( 137 , 138 ).…”