Strengthening the study of chronic hepatitis E / 中华肝脏病杂志

This paper summarizes the incidence, modes of transmission, diagnosis, treatment and prevention of chronic hepatitis E.

Flambée épidémique d'hépatite virale à forte létalité dans la région de Diffa (Niger) en 2017

Introduction. En 2017, la région de Diffa a notifié une hausse des cas de syndrome ictérique à huit cas dont 6 (75%) décès. Suite à la confirmation, une équipe multidisciplinaire a investigué cette flambée épidémique. L'objectif était de caractériser la population à risque, d'identifier la source de l'infection et de mettre en place des mesures de contrôle et de prévention. Méthodes. Nous avons conduit une étude descriptive des cas d'HVE survenus dans la région de Diffa, du 23 avril au 4 juin 2017. Une recherche active des cas a été menée dans les villages et les camps des réfugiés et des déplacés internes. Nous avons effectué des entretiens avec les malades et une revue documentaire. Une liste linéaire a été établie. Des prélèvements ont été collectés. Epi Info 7.2 pour l'analyse. Résultats. 329 cas dont 26 (7,90%) décès ont été enregistrés. Le sexe féminin représentait 63,1%. L'âge médian était de 26 ans (2 à 75 ans). La tranche d'âge ≥15 ans représentait 85,41%. Les femmes enceintes ou allaitantes représentaient 38,16% de l'effectif. Les signes cliniques étaient une fièvre, des céphalées, ictère, d'asthénies, de myalgies, d'arthralgies. Les populations se ravitaillaient en eau de boisson au niveau des abreuvoirs destinés aux animaux. La défécation se faisait à l'air libre dans les camps de réfugiés et des déplacés. Conclusion. L'investigation de l'épidémie a permis de décrire les cas et mettre en place des mesures de contrôle et de prévention. Nous recommandons de sensibiliser les populations sur l'hygiène et assainissement

Hepatites virais: abordagem clínica com ênfase nos vírus A e E / Viral hepatitis: clinical approach with emphasis on A and E viruses

JUSTIFICATIVA E OBJETIVOS: As hepatites virais são condições mórbidas extremamente comuns na prática clínica. Diferentes agentes etiológicos estão implicados no desenvolvimento da doença, especialmente os vírus A, B, C, D e E. O objetivo do presente artigo foi apresentar os aspectos gerais das hepatites desencadeadas por agentes virais, enfatizando-se as hepatites causadas pelos vírus A e E. CONTEÚDO: Foram utilizadas as palavras-chaves hepatites virais, hepatite A e hepatite E como descritores na pesquisa de dados nas bases Scielo (Scientific Eletronic Library Online) e Pubmed (U. S. National Library of Medicine), assim como livros texto,consensos e diretrizes relacionados ao tema. CONCLUSÃO: A ocorrência das hepatites causadas pelos vírus A e E está intimamente relacionada ao nível socioeconômico e às condições sanitárias da população, haja vista a transmissão ocorrer predominantemente por via fecal-oral. Embora ambas as entidades nosológicas apresentem evolução benigna na maioria dos casos, a educação sanitária e a promoção da saúde representam estratégias promissoras para a melhoria das condições de vida das populações suscetíveis.

BACKGROUND AND OBJECTIVES: Viral hepatitis is a morbid condition extremely common in practical clinic. Different etiological agents are implicated in the development of illness, especially viruses A, B, C, D and E. The objective of this study is to present general aspects of hepatitis triggered by viral agents,with emphasis on hepatitis caused by viruses A and E. CONTENTS: We used the keywords viral hepatitis, hepatitis A and hepatitis E as descriptors in the data search Scielo (Scientific Electronic Library Online) and Pubmed (U. S. National Library of Medicine), as well as textbooks, consensus and guidelines related to the topic. CONCLUSION: The occurrence of hepatitis caused by viruses A and E is closely related to socioeconomic status and sanitary conditions of the population, since the transmission occurs predominantly via the faecal-oral route. Although both nosological entities have a benign course in most cases, health education and health promotion represent promising strategies for improving the living conditions of susceptible populations.

Transfusion-transmitted hepatitis E: Is screening warranted.

Hepatitis E virus (HEV) is an emerging infectious threat to blood safety. In recent years, there have been a number of publications delineating this threat by providing evidence of the transmissibility of this virus through transfusions. The extent of transmission and its clinical relevance are issues under debate at present. HEV usually causes a self-limiting illness which subsides in a few weeks barring a few cases where fulminant hepatic failure occurs. The virus poses a risk of higher morbidity and mortality in pregnant females, patients with pre-existing liver disease and solid organ transplant recipients. As these categories of patient often require repeated transfusions or massive transfusions, they are exposed to a greater risk of transmission of HEV. At present, there is little evidence to advocate universal screening for this virus but considering that there is no definitive treatment for HEV induced hepatitis, selective screening should be advocated in blood products for high risk recipients in endemic areas.

Hepatitis E en niños / Hepatitis E in children

La hepatitis E, conocida previamente como hepatitis no A, no B, de transmisión enteral, es una infección causada por el virus de la hepatitis E (VHE), cuyas características clínicas y epidemiológicas son las de una hepatitis aguda. Pertenece a la familia Hepaviridae. El VHE setransmite principalmente por la vía fecal-oral, la mayoría de las epidemias se pueden asociar conbrotes que tienen su origen en el agua, alta densidad de población y deficientes condiciones sanitarias. El cuadro clínico es el de una hepatitis aguda típica, sin embargo, tiene un amplio espectro de presentación clínica. Es común encontrar marcadores serológicos para VHE positivos en niños con hepatitis viral aguda por otros virus hepatótropos, especialmente el virus B y C. El diagnóstico de infección por VHE se puede hacer por detección serológica y/o molecular. La teórica viabilidad de una vacuna frente alVHEestá basada en diversas evidencias.

Hepatitis E, formerly known as hepatitis non A, non B, enteral transmission, is an infection causedby the hepatitis E virus (HEV), clinical and epidemiological characteristics are those of acute hepatitis. Hepaviridae belongs to the family. HEV is transmitted primarily through fecal-oral route,most outbreaks have been associated with outbreaks that have their origin in water, high population density and poor sanitation. The clinical picture is that of a typical acute hepatitis, however, has a broad spectrum of clinical presentation. Commonly found positive for HEV serological markers in children with acute viral hepatitis other hepatotropic viruses, especially viruses B and C. The diagnosis of HEV infectionan be done by serological detection and/or molecular. The theoretical feasibility of a vaccineagainstHEVis based on different evidence.

Seroepidemiology of hepatitis E virus infection in 2-25-year-olds in Sari district, Islamic Republic of Iran

The seroprevalence of hepatitis E virus infection [HEV] in children and young adults was determined in a community-based survey in an area of northern Islamic Republic of Iran. Serum samples were taken from 1080 randomly selected apparently healthy 2-25-year-olds from urban and rural regions of Sari district. Anti-HEV IgG antibodies were detected in 25 individuals [2.3%]. Seroprevalence increased significantly with age from 3/255 [1.2%] in children < 10 years to 8/110 [7.3%] in those aged 20-25 years. No differences in HEV status were noted between the sexes. Earlier age at exposure to infection and a higher infection rate were found in people residing in rural areas than in urban areas

Co-infection of hepatitis A and E with Salmonella infection; a case report

Ours is a developing country so infectious diseases contribute maximum to the morbidity and mortality. Among these, water borne diseases like diarrhea, typhoid, infectious hepatitis etc. are on rise. Sometimes more than one type of infection coexists which makes the diagnosis and management a challenging task. We report a case of Coinfection of Salmonella typhi with Hepatitis A and E. A 5 year old male child came to us with complaints of fever and jaundice for last 9 days. Blood culture of patient was positive for Salmonella typhi. Viral markers turned out to be positive for Hepatitis A and E. To the best of our knowledge coinfection of Hepatitis A and E with Salmonella has rarely been reported earlier. In view of the restricted finances in our country vaccines against typhoid and Hepatitis A can not be incorporated in the national immunization schedule at present but these vaccines can be offered on an individual basis

Sero-epidemiology of hepatitis E virus infection in Isfahan-Iran: a community-based study

Hepatitis E virus [HEV] is an enterically transmitted acute viral hepatitis with the highest incidence in Asia, Africa, Middle East and Central America. There is little published data on the epidemiology of the infection in Iran. Thus, this study was carried out to evaluate anti-HEV sero-prevalence in Isfahan Province [Iran]. In a cross sectional study extending over 6 years, 816 subjects were selected from urban and rural areas of Isfahan Province in 2005 using multi stage cluster sampling method. Demographic data and blood samples were collected and anti-HEV antibodies were measured by ELISA method. Chi-square test was used for statistical analysis and P<0.05 was considered significant. The subjects of this study included 428 females [52.5%] and 388 males [47.5%]. The overall anti-HEV sero-prevalence rate was 3.8%. There was no significant difference in HEV sero-positivity between the subjects grouped according to sex [4.2% in females and 3.4% in males, P=0.78], household number [P=0.095] and living area [2.7% in rural and 4.1% in urban areas, P=0.09]. HEV sero-prevalence increased with age from 0.9% in children 6-9 years to 8% in persons over 50 years without statistical differences in them [P=0.08]. There was statistical difference between HEV sero-positivity in different regions of Isfahan Province, with the highest prevalence in Khomeini Shahr [13.3%] [P< 0.001]. HEV sero-prevalence in Isfahan Province is lower than previous reports from other parts of Iran and Middle East. Further -studies in other parts of Iran are needed to obtain a prevalence map for planning preventional strategies

Cambios en la epidemiología de las hepatitis virales en Chile y consideraciones en estrategias de prevención / The changing epidemiology of viral hepatitis in Chile

The social and sanitary changes that Chile is experiencing will change the epidemiologic profile of viral hepatitis. Virus A hepatitis will displace to older ages, and immunization plans with specific vaccines should be considered. The real prevalence of hepatitis B may be higher, due to an underreporting of the disease. The education and vaccination of high risk groups should be reinforced. E virus hepatitis requires more research in risk groups and in certain animal species consumed by humans. C virus hepatitis is the greatest challenge as it causes chronic liver disease and is the main cause for liver transplantation.

Hepatites virais agudas: uma abordagem prática para o clínico / Acute viral hepatitis: a practical approach for the clinician

O autor faz uma revisäo dos principais aspectos clínicos, terapêuticos e profiláticos das hepatites virais agudas, de uma forma prática para o clínico.