Acute hepatitis E infection accounts for some cases of suspected drug-induced liver injury.
Acute hepatitis E infection accounts for some cases of suspected drug-induced liver injury.
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DOI：
10.1053/j.gastro.2011.07.051
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发表时间：
2011-11
期刊：
影响因子：
29.4
通讯作者：
Drug-Induced Liver Injury Network (DILIN)
中科院分区：
文献类型：
--
作者：
Davern TJ;Chalasani N;Fontana RJ;Hayashi PH;Protiva P;Kleiner DE;Engle RE;Nguyen H;Emerson SU;Purcell RH;Tillmann HL;Gu J;Serrano J;Hoofnagle JH;Drug-Induced Liver Injury Network (DILIN)
药物性肝损伤的诊断依赖于排除其他原因，包括甲型、乙型和丙型病毒性肝炎。戊型肝炎病毒 (HEV) 感染被认为是疑似药物性肝病的另一个原因。我们评估了美国药物性肝损伤患者中 HEV 感染的频率。药物性肝损伤网络（DILIN）是一项针对疑似药物性肝损伤患者的前瞻性研究；收集临床信息和生物样本以研究发病机制和疾病进展。我们分析了从参加 DILIN 的患者收集的血清样本，检测抗 HEV 的免疫球蛋白 (Ig)G 和 IgM；对所选样本进行 HEV RNA 检测。在 318 例疑似药物性肝损伤的患者中，50 例（16%）抗 HEV IgG 检测呈阳性，9 例（3%）抗 HEV IgM 检测呈阳性。含有抗 HEV IgM 的样本（在症状出现后 2 至 24 周收集）包括 4 个 HEV RNA 检测呈阳性（基因型 3）的样本。6 个月随访的样本来自 4 名患者；他们的抗 HEV IgM 呈阴性，但抗 HEV IgG 水平随着时间的推移而增加。具有抗 HEV IgM 的患者大多来自老年男性（89%；平均年龄 67 岁），其中 2 例 HIV 呈阳性。对 9 名抗 HEV IgM 患者的临床重新评估表明，急性戊型肝炎是 7 名患者最有可能的诊断，并且可能是 2 名患者的主要诊断。HEV 感染在怀疑由药物引起的急性肝损伤病例中占一小部分但很重要。应进行 HEV 感染的血清学检测，特别是在临床特征与急性病毒性肝炎相符的情况下。
The diagnosis of drug-induced liver injury relies upon exclusion of other causes, including viral hepatitis A, B, and C. Hepatitis E virus (HEV) infection has been proposed as another cause of suspected drug-induced liver disease. We assessed the frequency of HEV infection among patients with drug-induced liver injury in the United States. The drug-induced liver injury network (DILIN) is a prospective study of patients with suspected drug-induced liver injury; clinical information and biological samples are collected to investigate pathogenesis and disease progression. We analyzed serum samples, collected from patients enrolled in DILIN, for immunoglobulin (Ig)G and IgM against HEV; selected samples were tested for HEV RNA. Among 318 patients with suspected drug-induced liver injury, 50 (16%) tested positive for anti-HEV IgG and 9 (3%) for anti-HEV IgM. The samples that contained anti-HEV IgM (collected 2 to 24 weeks after onset of symptoms) included 4 that tested positive for HEV RNA, genotype 3. Samples from the 6-month follow-up visit were available from 4 patients; they were negative for anti-HEV IgM, but levels of anti-HEV IgG increased with time. Patients that had anti-HEV IgM were mostly from older men (89%; mean age, 67 years) and 2 were HIV positive. Clinical reassessment of the 9 patients with anti-HEV IgM indicated that acute hepatitis E was the most likely diagnosis for 7 and might be the primary diagnosis for 2. HEV infection contributes to a small but important proportion of cases of acute liver injury that are suspected of being drug induced. Serologic testing for HEV infection should be performed—particularly if clinical features are compatible with acute viral hepatitis.
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DOI：
10.1086/599319
发表时间：
2009-07-01
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Kuniholm MH;Purcell RH;McQuillan GM;Engle RE;Wasley A;Nelson KE
通讯作者：
Nelson KE
影响因子：
9.4
作者：
Meng, XJ;Wiseman, B;Purcell, RH
通讯作者：
Purcell, RH
影响因子：
158.5
作者：
Kamar, Nassim;Selves, Janick;Rostaing, Lionel
通讯作者：
Rostaing, Lionel
影响因子：
4.2
作者：
Fontana RJ;Watkins PB;Bonkovsky HL;Chalasani N;Davern T;Serrano J;Rochon J;DILIN Study Group
通讯作者：
DILIN Study Group
DOI：
10.1097/meg.0b013e3282f5195a
发表时间：
2008-08-01
影响因子：
2.1
作者：
Dalton, Harry R.;Stableforth, William;Bendall, Richard R.
通讯作者：
Bendall, Richard R.