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Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study
Summary Background In developed countries, hepatitis E is a porcine zoonosis caused by hepatitis E virus (HEV) genotype 3. In developing countries, hepatitis E is mainly caused by genotype 1, and causes increased mortality in patients with pre‐existing chronic liver disease (CLD). Aim To determine t...
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| Published in: | Alimentary pharmacology & therapeutics 2015-09, Vol.42 (5), p.574-581 |
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| creator | Blasco‐Perrin, H. Madden, R. G. Stanley, A. Crossan, C. Hunter, J. G. Vine, L. Lane, K. Devooght‐Johnson, N. Mclaughlin, C. Petrik, J. Stableforth, B. Hussaini, H. Phillips, M. Mansuy, J. M. Forrest, E. Izopet, J. Blatchford, O. Scobie, L. Peron, J. M. Dalton, H. R. |
| description | Summary
Background
In developed countries, hepatitis E is a porcine zoonosis caused by hepatitis E virus (HEV) genotype 3. In developing countries, hepatitis E is mainly caused by genotype 1, and causes increased mortality in patients with pre‐existing chronic liver disease (CLD).
Aim
To determine the role of HEV in patients with decompensated CLD.
Methods
Prospective HEV testing of 343 patients with decompensated CLD at three UK centres and Toulouse France, with follow‐up for 6 months or death. IgG seroprevalence was compared with 911 controls.
Results
11/343 patients (3.2%) had acute hepatitis E infection, and three died. There were no differences in mortality (27% vs. 26%, OR 1.1, 95% CI 0.28–4.1), age (P = 0.9), bilirubin (P = 0.5), alanine aminotransferase (P = 0.06) albumin (P = 0.5) or international normalised ratio (P = 0.6) in patients with and without hepatitis E infection. Five cases were polymerase chain reaction (PCR) positive (genotype 3). Hepatitis E was more common in Toulouse (7.9%) compared to the UK cohort (1.2%, P = 0.003). HEV IgG seroprevalence was higher in Toulouse (OR 17, 95% CI 9.2–30) and Truro (OR 2.5, 95% CI 1.4–4.6) than in Glasgow, but lower in cases, compared to controls (OR 0.59, 95% CI 0.41–0.86).
Conclusions
Hepatitis E occurs in a minority of patients with decompensated chronic liver disease. The mortality is no different to the mortality in patients without hepatitis E infection. The diagnosis can only be established by a combination of serology and PCR, the yield and utility of which vary by geographical location. |
| doi_str_mv | 10.1111/apt.13309 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1701895720</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1701895720</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3609-3f341138e03c0762a96705605b9b33925b54bed0b0193b1bd40f4a3ffe590533</originalsourceid><addsrcrecordid>eNp1kLFOwzAURS0EoqUw8APIIwxpn-PEqdmqqqWISjCUOXKcF9UoSUPstOrf4xJg4y1Pujq6ujqE3DIYM38T1bgx4xzkGRkyLuIgBC7OyRBCIYNwyviAXFn7AQAigfCSDELBkihKYEhwhY1yxhlLF3Rv2s5SU9NThLWz9GDcluaod1WDtVUOc6q37a42mpZmjy3NjUVl8ZEq2rQ726B2PqfvL5Nli7XeUuu6_HhNLgpVWrz5-SOyWS4281Wwfn16ns_WgeYCZMALHjHGpwhcQyJCJf3eWECcyYxzGcZZHGWYQwZM8oxleQRFpHhRYCwh5nxE7vtaP-WzQ-vSyliNZalq3HU2ZQmwqYwTr2dEHnpU-9W2xSJtWlOp9pgySE9SUy81_Zbq2buf2i6rMP8jfy16YNIDB1Pi8f-mdPa26Su_AC_rgGo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1701895720</pqid></control><display><type>article</type><title>Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study</title><source>Wiley</source><creator>Blasco‐Perrin, H. ; Madden, R. G. ; Stanley, A. ; Crossan, C. ; Hunter, J. G. ; Vine, L. ; Lane, K. ; Devooght‐Johnson, N. ; Mclaughlin, C. ; Petrik, J. ; Stableforth, B. ; Hussaini, H. ; Phillips, M. ; Mansuy, J. M. ; Forrest, E. ; Izopet, J. ; Blatchford, O. ; Scobie, L. ; Peron, J. M. ; Dalton, H. R.</creator><creatorcontrib>Blasco‐Perrin, H. ; Madden, R. G. ; Stanley, A. ; Crossan, C. ; Hunter, J. G. ; Vine, L. ; Lane, K. ; Devooght‐Johnson, N. ; Mclaughlin, C. ; Petrik, J. ; Stableforth, B. ; Hussaini, H. ; Phillips, M. ; Mansuy, J. M. ; Forrest, E. ; Izopet, J. ; Blatchford, O. ; Scobie, L. ; Peron, J. M. ; Dalton, H. R.</creatorcontrib><description>Summary
Background
In developed countries, hepatitis E is a porcine zoonosis caused by hepatitis E virus (HEV) genotype 3. In developing countries, hepatitis E is mainly caused by genotype 1, and causes increased mortality in patients with pre‐existing chronic liver disease (CLD).
Aim
To determine the role of HEV in patients with decompensated CLD.
Methods
Prospective HEV testing of 343 patients with decompensated CLD at three UK centres and Toulouse France, with follow‐up for 6 months or death. IgG seroprevalence was compared with 911 controls.
Results
11/343 patients (3.2%) had acute hepatitis E infection, and three died. There were no differences in mortality (27% vs. 26%, OR 1.1, 95% CI 0.28–4.1), age (P = 0.9), bilirubin (P = 0.5), alanine aminotransferase (P = 0.06) albumin (P = 0.5) or international normalised ratio (P = 0.6) in patients with and without hepatitis E infection. Five cases were polymerase chain reaction (PCR) positive (genotype 3). Hepatitis E was more common in Toulouse (7.9%) compared to the UK cohort (1.2%, P = 0.003). HEV IgG seroprevalence was higher in Toulouse (OR 17, 95% CI 9.2–30) and Truro (OR 2.5, 95% CI 1.4–4.6) than in Glasgow, but lower in cases, compared to controls (OR 0.59, 95% CI 0.41–0.86).
Conclusions
Hepatitis E occurs in a minority of patients with decompensated chronic liver disease. The mortality is no different to the mortality in patients without hepatitis E infection. The diagnosis can only be established by a combination of serology and PCR, the yield and utility of which vary by geographical location.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.13309</identifier><identifier>PMID: 26174470</identifier><language>eng</language><publisher>England</publisher><subject>Adult ; Alanine Transaminase - blood ; Bilirubin - blood ; End Stage Liver Disease - epidemiology ; End Stage Liver Disease - virology ; Female ; France - epidemiology ; Genotype ; Hepatitis E - diagnosis ; Hepatitis E virus - genetics ; Humans ; Immunoglobulin G - blood ; Male ; Middle Aged ; Prospective Studies ; Seroepidemiologic Studies ; United Kingdom - epidemiology</subject><ispartof>Alimentary pharmacology & therapeutics, 2015-09, Vol.42 (5), p.574-581</ispartof><rights>2015 John Wiley & Sons Ltd</rights><rights>2015 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3609-3f341138e03c0762a96705605b9b33925b54bed0b0193b1bd40f4a3ffe590533</citedby><cites>FETCH-LOGICAL-c3609-3f341138e03c0762a96705605b9b33925b54bed0b0193b1bd40f4a3ffe590533</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fapt.13309$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fapt.13309$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,786,790,27957,27958,50923,51032</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26174470$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Blasco‐Perrin, H.</creatorcontrib><creatorcontrib>Madden, R. G.</creatorcontrib><creatorcontrib>Stanley, A.</creatorcontrib><creatorcontrib>Crossan, C.</creatorcontrib><creatorcontrib>Hunter, J. G.</creatorcontrib><creatorcontrib>Vine, L.</creatorcontrib><creatorcontrib>Lane, K.</creatorcontrib><creatorcontrib>Devooght‐Johnson, N.</creatorcontrib><creatorcontrib>Mclaughlin, C.</creatorcontrib><creatorcontrib>Petrik, J.</creatorcontrib><creatorcontrib>Stableforth, B.</creatorcontrib><creatorcontrib>Hussaini, H.</creatorcontrib><creatorcontrib>Phillips, M.</creatorcontrib><creatorcontrib>Mansuy, J. M.</creatorcontrib><creatorcontrib>Forrest, E.</creatorcontrib><creatorcontrib>Izopet, J.</creatorcontrib><creatorcontrib>Blatchford, O.</creatorcontrib><creatorcontrib>Scobie, L.</creatorcontrib><creatorcontrib>Peron, J. M.</creatorcontrib><creatorcontrib>Dalton, H. R.</creatorcontrib><title>Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background
In developed countries, hepatitis E is a porcine zoonosis caused by hepatitis E virus (HEV) genotype 3. In developing countries, hepatitis E is mainly caused by genotype 1, and causes increased mortality in patients with pre‐existing chronic liver disease (CLD).
Aim
To determine the role of HEV in patients with decompensated CLD.
Methods
Prospective HEV testing of 343 patients with decompensated CLD at three UK centres and Toulouse France, with follow‐up for 6 months or death. IgG seroprevalence was compared with 911 controls.
Results
11/343 patients (3.2%) had acute hepatitis E infection, and three died. There were no differences in mortality (27% vs. 26%, OR 1.1, 95% CI 0.28–4.1), age (P = 0.9), bilirubin (P = 0.5), alanine aminotransferase (P = 0.06) albumin (P = 0.5) or international normalised ratio (P = 0.6) in patients with and without hepatitis E infection. Five cases were polymerase chain reaction (PCR) positive (genotype 3). Hepatitis E was more common in Toulouse (7.9%) compared to the UK cohort (1.2%, P = 0.003). HEV IgG seroprevalence was higher in Toulouse (OR 17, 95% CI 9.2–30) and Truro (OR 2.5, 95% CI 1.4–4.6) than in Glasgow, but lower in cases, compared to controls (OR 0.59, 95% CI 0.41–0.86).
Conclusions
Hepatitis E occurs in a minority of patients with decompensated chronic liver disease. The mortality is no different to the mortality in patients without hepatitis E infection. The diagnosis can only be established by a combination of serology and PCR, the yield and utility of which vary by geographical location.</description><subject>Adult</subject><subject>Alanine Transaminase - blood</subject><subject>Bilirubin - blood</subject><subject>End Stage Liver Disease - epidemiology</subject><subject>End Stage Liver Disease - virology</subject><subject>Female</subject><subject>France - epidemiology</subject><subject>Genotype</subject><subject>Hepatitis E - diagnosis</subject><subject>Hepatitis E virus - genetics</subject><subject>Humans</subject><subject>Immunoglobulin G - blood</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Seroepidemiologic Studies</subject><subject>United Kingdom - epidemiology</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNp1kLFOwzAURS0EoqUw8APIIwxpn-PEqdmqqqWISjCUOXKcF9UoSUPstOrf4xJg4y1Pujq6ujqE3DIYM38T1bgx4xzkGRkyLuIgBC7OyRBCIYNwyviAXFn7AQAigfCSDELBkihKYEhwhY1yxhlLF3Rv2s5SU9NThLWz9GDcluaod1WDtVUOc6q37a42mpZmjy3NjUVl8ZEq2rQ726B2PqfvL5Nli7XeUuu6_HhNLgpVWrz5-SOyWS4281Wwfn16ns_WgeYCZMALHjHGpwhcQyJCJf3eWECcyYxzGcZZHGWYQwZM8oxleQRFpHhRYCwh5nxE7vtaP-WzQ-vSyliNZalq3HU2ZQmwqYwTr2dEHnpU-9W2xSJtWlOp9pgySE9SUy81_Zbq2buf2i6rMP8jfy16YNIDB1Pi8f-mdPa26Su_AC_rgGo</recordid><startdate>201509</startdate><enddate>201509</enddate><creator>Blasco‐Perrin, H.</creator><creator>Madden, R. G.</creator><creator>Stanley, A.</creator><creator>Crossan, C.</creator><creator>Hunter, J. G.</creator><creator>Vine, L.</creator><creator>Lane, K.</creator><creator>Devooght‐Johnson, N.</creator><creator>Mclaughlin, C.</creator><creator>Petrik, J.</creator><creator>Stableforth, B.</creator><creator>Hussaini, H.</creator><creator>Phillips, M.</creator><creator>Mansuy, J. M.</creator><creator>Forrest, E.</creator><creator>Izopet, J.</creator><creator>Blatchford, O.</creator><creator>Scobie, L.</creator><creator>Peron, J. M.</creator><creator>Dalton, H. R.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201509</creationdate><title>Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study</title><author>Blasco‐Perrin, H. ; Madden, R. G. ; Stanley, A. ; Crossan, C. ; Hunter, J. G. ; Vine, L. ; Lane, K. ; Devooght‐Johnson, N. ; Mclaughlin, C. ; Petrik, J. ; Stableforth, B. ; Hussaini, H. ; Phillips, M. ; Mansuy, J. M. ; Forrest, E. ; Izopet, J. ; Blatchford, O. ; Scobie, L. ; Peron, J. M. ; Dalton, H. R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3609-3f341138e03c0762a96705605b9b33925b54bed0b0193b1bd40f4a3ffe590533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Alanine Transaminase - blood</topic><topic>Bilirubin - blood</topic><topic>End Stage Liver Disease - epidemiology</topic><topic>End Stage Liver Disease - virology</topic><topic>Female</topic><topic>France - epidemiology</topic><topic>Genotype</topic><topic>Hepatitis E - diagnosis</topic><topic>Hepatitis E virus - genetics</topic><topic>Humans</topic><topic>Immunoglobulin G - blood</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Seroepidemiologic Studies</topic><topic>United Kingdom - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Blasco‐Perrin, H.</creatorcontrib><creatorcontrib>Madden, R. G.</creatorcontrib><creatorcontrib>Stanley, A.</creatorcontrib><creatorcontrib>Crossan, C.</creatorcontrib><creatorcontrib>Hunter, J. G.</creatorcontrib><creatorcontrib>Vine, L.</creatorcontrib><creatorcontrib>Lane, K.</creatorcontrib><creatorcontrib>Devooght‐Johnson, N.</creatorcontrib><creatorcontrib>Mclaughlin, C.</creatorcontrib><creatorcontrib>Petrik, J.</creatorcontrib><creatorcontrib>Stableforth, B.</creatorcontrib><creatorcontrib>Hussaini, H.</creatorcontrib><creatorcontrib>Phillips, M.</creatorcontrib><creatorcontrib>Mansuy, J. M.</creatorcontrib><creatorcontrib>Forrest, E.</creatorcontrib><creatorcontrib>Izopet, J.</creatorcontrib><creatorcontrib>Blatchford, O.</creatorcontrib><creatorcontrib>Scobie, L.</creatorcontrib><creatorcontrib>Peron, J. M.</creatorcontrib><creatorcontrib>Dalton, H. R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Blasco‐Perrin, H.</au><au>Madden, R. G.</au><au>Stanley, A.</au><au>Crossan, C.</au><au>Hunter, J. G.</au><au>Vine, L.</au><au>Lane, K.</au><au>Devooght‐Johnson, N.</au><au>Mclaughlin, C.</au><au>Petrik, J.</au><au>Stableforth, B.</au><au>Hussaini, H.</au><au>Phillips, M.</au><au>Mansuy, J. M.</au><au>Forrest, E.</au><au>Izopet, J.</au><au>Blatchford, O.</au><au>Scobie, L.</au><au>Peron, J. M.</au><au>Dalton, H. R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2015-09</date><risdate>2015</risdate><volume>42</volume><issue>5</issue><spage>574</spage><epage>581</epage><pages>574-581</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Summary
Background
In developed countries, hepatitis E is a porcine zoonosis caused by hepatitis E virus (HEV) genotype 3. In developing countries, hepatitis E is mainly caused by genotype 1, and causes increased mortality in patients with pre‐existing chronic liver disease (CLD).
Aim
To determine the role of HEV in patients with decompensated CLD.
Methods
Prospective HEV testing of 343 patients with decompensated CLD at three UK centres and Toulouse France, with follow‐up for 6 months or death. IgG seroprevalence was compared with 911 controls.
Results
11/343 patients (3.2%) had acute hepatitis E infection, and three died. There were no differences in mortality (27% vs. 26%, OR 1.1, 95% CI 0.28–4.1), age (P = 0.9), bilirubin (P = 0.5), alanine aminotransferase (P = 0.06) albumin (P = 0.5) or international normalised ratio (P = 0.6) in patients with and without hepatitis E infection. Five cases were polymerase chain reaction (PCR) positive (genotype 3). Hepatitis E was more common in Toulouse (7.9%) compared to the UK cohort (1.2%, P = 0.003). HEV IgG seroprevalence was higher in Toulouse (OR 17, 95% CI 9.2–30) and Truro (OR 2.5, 95% CI 1.4–4.6) than in Glasgow, but lower in cases, compared to controls (OR 0.59, 95% CI 0.41–0.86).
Conclusions
Hepatitis E occurs in a minority of patients with decompensated chronic liver disease. The mortality is no different to the mortality in patients without hepatitis E infection. The diagnosis can only be established by a combination of serology and PCR, the yield and utility of which vary by geographical location.</abstract><cop>England</cop><pmid>26174470</pmid><doi>10.1111/apt.13309</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0269-2813 |
| ispartof | Alimentary pharmacology & therapeutics, 2015-09, Vol.42 (5), p.574-581 |
| issn | 0269-2813 1365-2036 |
| language | eng |
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| source | Wiley |
| subjects | Adult Alanine Transaminase - blood Bilirubin - blood End Stage Liver Disease - epidemiology End Stage Liver Disease - virology Female France - epidemiology Genotype Hepatitis E - diagnosis Hepatitis E virus - genetics Humans Immunoglobulin G - blood Male Middle Aged Prospective Studies Seroepidemiologic Studies United Kingdom - epidemiology |
| title | Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study |
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