Superimposed acute hepatitis E infection in patients with chronic liver disease.
Artículo
en Inglés
| IMSEAR
| ID: sea-65272
ABSTRACT
BACKGROUND:
The natural history of infection with hepatitis E virus (HEV) in patients with chronic liver disease (CLD) is not well described. Our study aims to document the presentation, course and outcome of HEV superinfection in patients with CLD.METHODS:
Over an 18-month period, ten patients with CLD were diagnosed to have HEV superinfection by detection of anti-HEV IgM antibodies in a setting of acute worsening. These patients were tested for HBsAg, IgM anti-HBc, anti-hepatitis C virus antibodies and IgM anti-hepatitis A virus antibodies, and were followed-up.RESULTS:
The etiology of underlying CLD in the 10 patients (9 men; mean [SD] age 42.4 [10.3] years) was alcohol in five patients, hepatitis B in two, hepatitis C in one and cryptogenic in two. Seven patients presented for the first time with recent-onset liver decompensation (median duration 27 days, range 7-45). All 10 had ascites and 7 had hepatic encephalopathy. Four patients developed renal failure during the course of illness. The median (range) bilirubin, ALT and albumin levels at presentation were 18.6 (4.9-32.6) mg/dL, 105 (28-6610) IU/L and 32 (29-41) g/L, respectively. At 8 weeks, only one patient had normalization of serum bilirubin or ALT levels. Three patients (30%) died, including two of renal failure and one of massive upper GI bleed.CONCLUSIONS:
Superinfection with HEV in patients with CLD causes severe liver decompensation, which is frequently complicated with hepatic encephalopathy and renal failure. Acute hepatitis E in these patients has a protracted course with high morbidity and mortality.
Texto completo:
Disponible
Índice:
IMSEAR (Asia Sudoriental)
Asunto principal:
Pronóstico
/
Índice de Severidad de la Enfermedad
/
Anciano
/
Femenino
/
Humanos
/
Masculino
/
Sobreinfección
/
Enfermedad Crónica
/
Tasa de Supervivencia
/
Muestreo
Tipo de estudio:
Estudio de etiología
/
Estudio pronóstico
/
Factores de riesgo
País/Región como asunto:
Asia
Idioma:
Inglés
Año:
2004
Tipo del documento:
Artículo
Similares
MEDLINE
...
LILACS
LIS