This article is more than 5 years old. Information may no longer be current.
HEV found among patients with severe acute liver injury
Click Here to Manage Email Alerts
A small percentage of patients with severe acute liver injury enrolled in the Scottish Liver Transplantation Unit tested positive for hepatitis E virus antibodies and RNA, according to data from a new study.
Researchers analyzed serum samples from 80 patients with severe acute liver injury enrolled in the transplantation unit in Edinburgh, Scotland, between December 2008 and May 2012. All patients underwent testing for the presence of hepatitis E virus (HEV) RNA, and any presence of anti-HEV IgM and IgG antibodies.
Ninety percent of the patients were anti-HEV IgG negative, anti-HEV IgM negative and negative for HEV RNA; 5% were anti-HEV IgG positive, anti-HEV IgM negative and HEV RNA negative; 3.75% were anti-HEV IgG positive, anti-HEV IgM positive and HEV RNA positive; and 1.25% were anti-HEV IgG positive, anti-HEV IgM positive and HEV RNA negative.
Of the entire cohort, patients with hepatitis B virus, hepatitis C virus, autoimmune hepatitis, post-liver transplant graft nonfunction, fatty liver of pregnancy, ischemic hepatitis, malignancy or acute porphyria were negative for HEV. One of the patients positive for HEV genotype 1 had returned from Asia; the other three patients were autochthonous and diagnosed through retrospective testing, including two diagnosed with genotype 3.
“In four of 80 of patients with acute liver injury severe enough to warrant assessment and treatment … the cause was hepatitis E,” the researchers wrote. “Only one of these patients had a history of travel to an area traditionally considered hyperendemic for HEV.
“This study shows that clinicians should have a low threshold for considering hepatitis E as a possible diagnosis in any patient with severe acute liver injury. This should include those with possible paracetamol hepatoxicity, irrespective of their age or travel history.”
Disclosure: Relevant financial disclosures were not provided by researchers.