Etiological role of hepatitis E virus in sporadic fulminant hepatitis

Nanda, Santosh Kumar; Yalçinkaya, Kezban Tülay; Panigrahi, Aswini K.; Acharya, Subrat Kumar; Jameel, Shahid; Panda, Subrat Kumar

doi:10.1002/jmv.1890420207

Cited by 95 publications

(74 citation statements)

References 32 publications

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“…16 HEV is predominantly transmitted through contaminated water and food. [1][2][3][4][5][6][7]14,15,[17][18][19][20][21] The disproportionate pregnancy rate among the women and girls with ALF in the current study may raise the suspicion of sexual transmission of HEV. However, sexual transmission of HEV has not been reported.…”

Section: Discussionmentioning

confidence: 99%

“…40 HEV as a cause of ALF has not been reported from the west, whereas it is the commonest cause of ALF in the current study as well as earlier reported studies from India. [3][4][5][6][7]11,12,14,15 At our center, liver transplant facilities are not available; therefore, the mortality rate of 57% documented in the current study would indicate the true frequency of death attributable to ALF. In the US multicenter study, 25% to 29% of patients with ALF were subjected to liver transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…IgM antibody to ORF-1, ORF-2, and ORF-3 of HEV and HEV RNA were tested by methods developed at our institute. 13,14 Anti-hepatitis C antibody was tested by using a third-generation, commercial enzyme-linked immunosorbent assay (Xcyton, Bangalore, India) method. Hepatitis C virus RNA was tested by reverse transcription nested polymerase chain reaction, using primers from the 5Ј nontranslated region, if appropriate by methods already described.…”

Section: Methodsmentioning

confidence: 99%

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A 20-year single-center experience with acute liver failure during pregnancy: Is the prognosis really worse?

et al. 2008

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Pregnant patients with acute liver failure (ALF) are believed to have a worse outcome than nonpregnant women and men with ALF. However objective data supporting this supposition are scant. Therefore, the current study compared the outcome, complications, and causes of ALF among pregnant women and girls with age-matched nonpregnant women and girls and men and boys with ALF. One thousand fifteen consecutive ALF patients in the reproductive age group, admitted at the All India Institute of Medical Sciences, New Delhi, from January 1986 to December 2006, were included in the study. A total of 249 (38.5%) women were pregnant. They were compared with 341 nonpregnant women and girls and 425 men and boys, aged 15 to 45 years. The mortality rate of pregnant women and girls (53.8%) was similar to age-matched nonpregnant women and girls (57.2%), and men and boys (57.9%); P ‫؍‬ 0.572.The clinical and biochemical features, disease severity, and complications were also similar in the three groups. A significantly higher proportion of ALF was attributable to hepatitis E virus (HEV) among women and girls who were pregnant (59.4%), as compared with both nonpregnant women and girls (30.4%), and men and boys (23.1%); P < 0.001. However, the outcome of HEV-related ALF was independent of the sex and pregnancy status of the patients (P ‫؍‬ 0.103). Mortality in HEV-ALF and non-HEV-ALF patients in pregnant women and girls was 51% (74/145) and 54.7% (52/ 95)(P > 0.1), respectively. The outcome of pregnant ALF patients was also unrelated to the trimester of pregnancy. The mortality of non-HEV-related ALF among the pregnant women and girls (54.7%), age-matched nonpregnant women and girls (61.7%), and men and boys (62.8%) were also similar (P > 0.1). Conclusion: The mortality of pregnant patients with ALF is similar to that of nonpregnant women and girls and men and boys and is independent of the cause or trimester. Pregnancy per se should not be regarded as a poor prognostic factor for a patient with ALF. (HEPATOLOGY 2008;48:1577-1585

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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A 20-year single-center experience with acute liver failure during pregnancy: Is the prognosis really worse?

et al. 2008

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“…This is due to the benign course of illness caused by this agent, with case fatality rates of around 0.1%-0.4% 1,14 Hepatitis E is the most common cause of ALF in endemic regions of the world, with high mortality (25%) in pregnant women ( Figure 3). [23][24][25][26] Hepatitis B has a case fatality of around 1.0% and constitutes a significant percent of ALF in various endemic regions of the world. 1,13 Chronic hepatitis B can cause ALF during reactivation, especially after immunosuppression therapy.…”

Section: Viral Hepatitismentioning

confidence: 99%

“…7 Hepatitis C is a very rare cause of ALF in Europe and the United States, 27,28 although a number of series from Japan and India have found evidence of hepatitis C in the non-A, non-B group of patients. 24,25,29 The etiology of ALF is unknown in 30%-50% of patients and is presumed to be caused by yet unidentified non-A-E viral agent. This non-A-E agent accounts for 90% of patients with late onset hepatic failure, and identification of this agent is a matter of great priority.…”

Section: Viral Hepatitismentioning

confidence: 99%

Acute Liver Failure

Khuroo

1998

Ann Saudi Med

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Acute viral hepatitis types E, A, and B singly and in combination in acute liver failure in children in North India

et al. 1996

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The aetiological agents responsible for, and the outcome of, acute liver failure were investigated prospectively in 44 children (29 males, 15 females) attending a tertiary health care facility in India. The children were between the ages of 2 months and 13 years. Studies for viral infections and other etiologies could be carried out in 40 patients. Specific aetiological labels were possible in 35 (87.5%) patients. Thirty (75%) had evidence of acute viral hepatitis. Acute hepatitis E virus (HEV) infection was found in a total of 18 children, with hepatitis A (HAV) in 16, hepatitis B in 5, and C in 1. Seven had isolated infection with hepatitis E, five with A, and four with B. Nine had both E and A infection. Superinfection of HEV was observed in a child with Indian childhood cirrhosis (ICC). Acute HEV infection was confirmed by immunoblot assay in all the patients and in eight of these, HEV-RNA was also detected in the serum. HAV was involved in 37.5% of cases with isolated infection in 10% (4 of 40). The aetiological factors associated with acute liver failure, apart from HAV and HEV, were other hepatotropic viruses (22.5%), Wilson's disease (5%), ICC (5%), and hepatotoxic drugs (7.5%). In five patients, no serological evidence of acute viral hepatitis could be found, neither did the metabolic screen yield any result. It was observed that enterically transmitted hepatitis viruses (HAV and HEV) were associated with 60% of acute hepatic failure in children. Mixed infection of HAV and HEV formed the single largest aetiological subgroup. In developing countries, where hepatitis A and E infections are endemic, severe complications can arise in the case of mixed infection. This may contribute to most of the mortality from acute liver failure during childhood.

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Etiological role of hepatitis E virus in sporadic fulminant hepatitis

Cited by 95 publications

References 32 publications

A 20-year single-center experience with acute liver failure during pregnancy: Is the prognosis really worse?

A 20-year single-center experience with acute liver failure during pregnancy: Is the prognosis really worse?

Acute Liver Failure

Acute viral hepatitis types E, A, and B singly and in combination in acute liver failure in children in North India

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