Host risk factors and autochthonous hepatitis E infection

Abstract

Clinically apparent hepatitis E infection is more common in individuals who consume at least 22 U alcohol/week. Patients with established chronic alcoholic liver disease have a low seroprevalence compared with controls. The reason for this observation is uncertain, but patients with alcoholic liver disease have clinically severe disease with a high mortality when exposed to HEV. The low seroprevalence in this group may represent a 'culled' population.

High prevalence of antibodies against hepatitis E virus in HIV-infected patients with unexplained liver disease

“…In fact, it has been hypothesized that subclinical hepatic steatosis or fibrosis could be a host risk factor for clinical disease expression in patients exposed to HEV. 13 Our objective was to look for evidence of HEV exposure in HIVinfected patients with unexplained elevations of LS.…”

Hepatitis E in patients with hepatic disorders and HIV-infected patients in Croatia: is one diagnostic method enough for hepatitis E diagnosis?

“…In developing regions outbreaks are generally caused by human specific genotypes 1 and 2 which are recognized as travel-associated HEV infections in developed countries. Genotypes 3 and 4 are considered to be causes of endemic infections with zoonotic potential since they were isolated from humans but also from different mammalian species and marine animals [4][5][6][7][8][9][10]. HEV is acquired through the fecal-oral route, although sources of HEV frequently stay unrecognized [4][5][6][7][8][9][10][11][12].…”

Coastal clustering of HEV; Cornwall, UK

“…Secondly, the route of exposure might influence clinical disease expression. Thirdly, host factors may play a role, as clinically overt hepatitis E infection appears to be more common in individuals who consume more than 22 units of alcohol per week [19]. We were unable to explore this latter possibility and its effect as a confounding variable as there are no local data on geographical differences in alcohol consumption.…”

“…Controls were age and sex matched to the cases in a ratio of 4:1. Due to postulated associations [19], control patients were excluded from the study if the cause of their jaundice was viral hepatitis or alcohol related disease. Control subjects were also excluded if they were not normally resident in Cornwall, for example holidaymakers.…”