The investigation of hepatitis A virus and hepatitis E virus co-infection in humans and animals in China

Li, M; Zhang, H; Wang, L; Li, Z; Wang, J; Xu, Bin; Hao, Rongzhang; Liu, C; Fu, Hongqiao; Rao, Huiying; Zhang, Hui

doi:10.4149/av_2020_103

Cited by 8 publications

(9 citation statements)

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“…It is also worthy to note that anti-HAV IgM were detected in presence of IgG, but in the absence of HAV RNA, suggesting recent resolved HAV infection or a false-positivity of anti-HAV IgM. The co-existence of anti-HEV and anti-HAV IgM was reported in previous studies and was interpreted as HEV and HAV coinfections, but in the absence of HEV RNA and HAV RNA testing, in all but one study [ 17 ]. Here, whether recent HAV infection had occurred and impacted the clinical outcome at the time of hepatitis E associated with excessive metformin dosage remain unresolved questions.…”

Section: Discussionmentioning

confidence: 68%

Fatal Fulminant Hepatitis E in a Diabetic Patient on Metformin

et al. 2022

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Hepatitis E is mostly autochthonous in Western developed countries, eating pig-derived products being the most frequently documented source. Hepatitis E virus (HEV) infection is usually asymptomatic or self-limiting, but it can cause acute liver failure. HEV serological testing was performed using EUROIMMUN immunoenzymatic assays. HEV RNA in the serum was determined using an in-house real-time reverse transcriptase PCR procedure. The HEV genotype was determined through phylogenetic analysis after Sanger sequencing was performed using an in-house procedure. The case patient, an immunocompetent patient in his 60s with type 2 diabetes and no documented chronic liver disease, was hospitalized in February 2021 in an intensive care unit due to an initially unexplained coma. He presented metformin overdose and fulminant hepatitis E (HEV RNA in the serum was 4,140,000 copies/mL) that evolved toward death. The HEV genotype was 3f. We identified eight previous hepatitis E in diabetic patients, but with no metformin excessive plasma concentration, in the literature. Three patients were liver transplant recipients and three died. HEV infection can be severe and life-threatening in diabetic patients, which warrants HEV testing in this special population in the case of an altered general condition and/or liver cytolysis.

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Section: Discussionmentioning

confidence: 68%

Fatal Fulminant Hepatitis E in a Diabetic Patient on Metformin

et al. 2022

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“…Several cases of HAV/HEV dual infection developed acalculous cholecystitis, hepatic encephalopathy, and the worst outcomes [ 116 , 117 , 118 ]. Other studies supported the finding that the HEV/HAV dual infection can lead to a severe course of the disease as shown by abnormalities in liver function tests or liver abnormalities [ 70 , 84 , 119 ]. Likewise, Paul and colleagues reported that the fatality rate associated with HEV infection was increased in pregnant women, as was the presence of dual infected hepatotropic viruses, especially HBV or HAV [ 75 ].…”

Section: Outcomes Of Dual Hav/hev Infectionmentioning

confidence: 74%

“…In China, among 46 acute hepatitis patients, five patients (10.87%) were HAV/HEV dual infected. The coinfected patients had higher liver transaminases, bilirubin, and jaundice compared to HEV or HAV-monoinfected patients [ 84 ]. The isolated HAV was genotype 1A, but HEV had not been characterized in this dual infection [ 84 ].…”

Section: Incidence Of Dual Infection Hav/hevmentioning

confidence: 99%

“…The coinfected patients had higher liver transaminases, bilirubin, and jaundice compared to HEV or HAV-monoinfected patients [ 84 ]. The isolated HAV was genotype 1A, but HEV had not been characterized in this dual infection [ 84 ]. In addition, HAV, HEV, and HAV/HEV dual infections were assessed in animals present there.…”

Section: Incidence Of Dual Infection Hav/hevmentioning

confidence: 99%

“…In addition, HAV, HEV, and HAV/HEV dual infections were assessed in animals present there. HEV RNA was detected only in rabbits and pigs, and HAV was detected only in ferrets, while dual infection HEV/HAV was not detected [ 84 ]. In Italy, HEV/HAV dual infection (14%) was recorded in MSM [ 49 ].…”

Section: Incidence Of Dual Infection Hav/hevmentioning

confidence: 99%

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Dual Infection of Hepatitis A Virus and Hepatitis E Virus— What Is Known?

Sayed

2023

Viruses

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Viral hepatitis is an infection of human hepatocytes resulting in liver damage. Dual infection of two hepatotropic viruses affects disease outcomes. The hepatitis A virus (HAV) and hepatitis E virus (HEV) are two enterically transmitted viruses; they are positive single-stranded RNA viruses and have common modes of transmission. They are transmitted mainly by the fecal-oral route and ingestion of contaminated food, though the HAV has no animal reservoirs. The HAV and HEV cause acute self-limiting disease; however, the HEV, but not HAV, can progress to chronic and extrahepatic infections. The HAV/HEV dual infection was reported among acute hepatitis patients present in developing countries. The impact of the HAV/HEV on the prognosis for acute hepatitis is not completely understood. Studies showed that the HAV/HEV dual infection increased abnormalities in the liver leading to fulminant hepatic failure (FHF) with a higher mortality rate compared to infection with a single virus. On the other hand, other reports showed that the clinical symptoms of the HAV/HEV dual infection were comparable to symptoms associated with the HAV or HEV monoinfection. This review highlights the modes of transmission, the prevalence of the HAV/HEV dual infection in various countries and among several study subjects, the possible outcomes of this dual infection, potential model systems for studying this dual infection, and methods of prevention of this dual infection and its associated complications.

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The Foodborne Transmission of Hepatitis E Virus to Humans

Treagus

Wright²,

Baker‐Austin

et al. 2021

Food Environ Virol

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Globally, Hepatitis E virus (HEV) causes over 20 million cases worldwide. HEV is an emerging and endemic pathogen within economically developed countries, chiefly resulting from infections with genotype 3 (G3) HEV. G3 HEV is known to be a zoonotic pathogen, with a broad host range. The primary source of HEV within more economically developed countries is considered to be pigs, and consumption of pork products is a significant risk factor and known transmission route for the virus to humans. However, other foods have also been implicated in the transmission of HEV to humans. This review consolidates the information available regarding transmission of HEV and looks to identify gaps where further research is required to better understand how HEV is transmitted to humans through food.

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The investigation of hepatitis A virus and hepatitis E virus co-infection in humans and animals in China

Cited by 8 publications

References 0 publications

Fatal Fulminant Hepatitis E in a Diabetic Patient on Metformin

Fatal Fulminant Hepatitis E in a Diabetic Patient on Metformin

Dual Infection of Hepatitis A Virus and Hepatitis E Virus— What Is Known?

The Foodborne Transmission of Hepatitis E Virus to Humans

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