Autochthonous hepatitis E in Southwest England: natural history, complications and seasonal variation, and hepatitis E virus IgG seroprevalence in blood donors, the elderly and patients with chronic liver disease
Autochthonous hepatitis E in Southwest England: natural history, complications and seasonal variation, and hepatitis E virus IgG seroprevalence in blood donors, the elderly and patients with chronic liver disease
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DOI：
10.1097/meg.0b013e3282f5195a
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发表时间：
2008-08-01
影响因子：
2.1
通讯作者：
Bendall, Richard R.
中科院分区：
文献类型：
--
作者：
Dalton, Harry R.;Stableforth, William;Bendall, Richard R.
目的报告的自然历史的本土戊型肝炎和戊型肝炎病毒（HEV）IgG血清阳性率在西南England.Methods不明原因的肝炎患者进行了戊型肝炎和病例，直到恢复或死亡。对500例献血员、336例60岁以上人群和126例慢性肝病患者进行了HEV IgG检测。戊型肝炎是无黄疸的25%的情况下，通常引起自限性肝炎，主要是在老年白人男性。40例患者中有6例出现严重并发症，3例患者死亡，其中2例先前未诊断为肝硬化。戊型肝炎呈季节性变化，春季和夏季为高峰，11月和12月无病例。HEV IgG的患病率随着年龄的增长而增加，男性更常见，献血员中为16%，慢性肝病患者中为13%，60岁以上的个体中为25%。它具有显著的发病率，并且在慢性肝病的背景下观察时具有不良预后。
Aims To report the natural history of autochthonous hepatitis E and hepatitis E virus (HEV) IgG seroprevalence in Southwest England.Methods Patients with unexplained hepatitis were tested for hepatitis E and cases followed until recovery or death. Five hundred blood donors, 336 individuals over the age of 60 years and 126 patients with chronic liver disease were tested for HEV IgG.Results Forty cases of autochthonous hepatitis E (genotype 3) were identified. Hepatitis E was anicteric in 25% of cases and usually caused a self-limiting hepatitis predominantly in elderly Caucasian males. Six of 40 had a significant complication and three patients died, two of who had previously undiagnosed cirrhosis. Hepatitis E shows a seasonal variation with peaks in the spring and summer and no cases in November and December. HEV IgG prevalence increases with age, is more common in men and is 16% in blood donors, 13% in patients with chronic liver disease and 25% in individuals over 60 years.Conclusion Autochthonous hepatitis E is more common than previously recognized, and should be considered in the differential diagnosis in patients with hepatitis, whatever their age or travel history. It carries a significant morbidity and when seen in the context of chronic liver disease carries an adverse prognosis.