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At least 19 recordsLinked to original sources

PubMed1992

[Immunohistochemical study of hepatitis E virus antigen in liver tissues from patients with type E hepatitis].

Hepatitis E virus antigen (HEV Ag) has been identified in liver tissues of 6 out of 14 patients with type E hepatitis by direct immunoperoxidase staining, using anti-HEV-IgG-HRP. HEV Ag was found to be diffusive or inclusive in the cytoplasm of hepatocytes were scattered and isolated, but might aggregate in some parts where the liver damage was severe. We found that lymphocyte invaded the HEV Ag positive hepatocyte. These phenomena suggest that the liver damage is related to immunoreaction. HEV Ag was not found in the liver tissues of stillborn fetus and newborn baby from woman patients with hepatitis E. To detect HEV Ag in liver with direct immunoperoxidase method, using anti-HEV-IgG-HRP is more efficient than using anti-HEV-IgM-HRP.

Antigens, Viral↗

PubMed2005

[Hepatitis E].

Hepatitis E is an important public health disease in developing countries where sanitary conditions are not well established. In developed countries, it is sporadic and mainly "imported". The causative agent of hepatitis E, hepatitis E virus (HEV), is a single-stranded positive-sense RNA virus, that belongs to the genus Hepevirus in the family Hepeviridae. Recent development of specific HEV RNA and HEV antibody detection revealed cases of indigenous HEV infection. Many cases are associated with uptake of raw meat of HEV-infected animals. Although the natural life cycle of HEV is not known, new aspects of HEV infection, zoonosis, is emerged.

Animals↗

PubMed2002

[A case of acute hepatitis E].

Hepatitis E is an infectious viral disease with clinical and morphologic features of acute hepatitis. Although HEV infection is endemic in the Indian subcontinent, Southeast and Central Asia, a large outbreak of hepatitis E was identified in China. Smaller outbreaks have been observed in the Middle East, northern and western parts of Africa, and Mexico. Sporadic hepatitis E also has been observed in several countries. In nonendemic regions, the sporadic cases of hepatitis E are almost always associated with travel to HEV-endemic regions. In Korea, there has been no report on hepatitis E. Recently, we experienced a case of acute icteric hepatitis in which serologic study showed seroconversion of IgM anti-HEV. The patient did not have any travel history to an HEV-endemic area. We report this as an initial case of acute hepatitis E in Korea.

Acute Disease↗

PubMed2001

Recombinant vaccines for hepatitis E.

Hepatitis E virus causes epidemics of acute hepatitis in many developing countries. It infrequently causes disease in developed countries, but avirulent strains might circulate. Some evidence suggests that hepatitis E might be a zoonosis. There is probably only a single serotype. A candidate vaccine consisting of baculovirus-expressed recombinant capsid protein protected macaques from hepatitis E--it passed phase I clinical trials and is currently scheduled for phase II/III clinical trials.

Animals↗

PubMed2000

Hepatitis E.

Hepatitis E, previously known as enterically transmitted non-A, non-B hepatitis, is an infectious viral disease with clinical and morphologic features of acute hepatitis. Its causative agent, hepatitis E virus, consists of small, 32- to 34-nm diameter, icosahedral, nonenveloped particles with a single-stranded, positive-sense, 7.5-kb RNA. The virus has two main geographically distinct strains, Asian and Mexican; recently, novel isolates from nonendemic areas and a genetically related swine HEV have been described. HEV is responsible for large epidemics of acute hepatitis and a proportion of sporadic hepatitis cases in the Indian subcontinent, southeast and central Asia, the Middle East, parts of Africa, and Mexico. The virus is excreted in feces and is transmitted predominantly by fecal-oral route, usually through contaminated water. Person-to-person transmission is uncommon. Clinical attack rates are the highest among young adults. Recent evidence suggests that humans with subclinical HEV infection and animals may represent reservoirs of HEV; however, further data are needed. Diagnosis of hepatitis E is usually made by detection of specific IgM antibody, which disappears rapidly over a few months; IgG anti-HEV persists for at least a few years. Clinical illness is similar to other forms of acute viral hepatitis except in pregnant women, in whom illness is particularly severe with a high mortality rate. Subclinical and unapparent infections may occur; however, chronic infection is unknown. No specific treatment is yet available. Use of clean drinking water and proper sanitation is currently the most effective method of prevention. Passive immunization has not been proved to be effective, and recombinant vaccines for travelers to disease-endemic areas and for pregnant women currently are being developed.

Age Factors↗

PubMed1996

Hepatitis E.

Hepatitis E has a world-wide distribution and causes substantial morbidity and mortality in some developing countries, particularly among pregnant women. Hepatitis E virus (HEV) has recently been cloned and sequenced, and new diagnostic tests have been developed. These tests have been used to begin to characterize the natural history and epidemiological features of HEV infection. Experimental vaccines have also been developed that offer the potential to prevent hepatitis E. However, much remains to be learned about HEV, including the mechanisms of transmission, the reservoir(s) of the virus, and the natural history of protective immunity in order to develop effective strategies to prevent this disease.

Adult↗

PubMedDate not supplied

Global epidemiology and medical aspects of hepatitis E.

Hepatitis E is a self-limited enterically transmitted acute viral hepatitis that occurs frequently in epidemic outbreaks and as sporadic hepatitis in the Indian sub-continent, Southeast and Central Asia, the Middle East, parts of Africa, and Mexico. Hepatitis E virus (HEV) is excreted in faeces and is transmitted predominantly by the faecal-oral route, usually through contaminated water. The reservoir of the virus during the inter-epidemic periods in disease-endemic countries may reside in the environment, in sub-clinically HEV-infected humans, and/or animals infected with an HEV-like virus. Chronic infection is unknown. Diagnosis of HEV infection is usually made by detection of anti-HEV antibodies or HEV-RNA in patients serum specimens. Clinical illness due to HEV infection is similar to other forms of viral hepatitis except in pregnant women, in whom the illness is particularly severe with a mortality as high as 25%. Asymptomatic and anicteric infections may occur. No specific treatment is available, and the most effective mode of preventing this disease is use of clean water and proper sanitation. Recombinant vaccines are being developed that may be particularly useful for travellers to the disease-endemic areas and for pregnant women.

Animals↗

PubMedDate not supplied

[Hepatitis E].

Hepatitis E virus (HEV) is the second most frequent hepatotropic virus transmitted via fecal-oral route, following closely behind hepatitis A virus. The great epidemics of hepatitis described during the 50s and 60s, in India, were caused by this virus. Epidemic bursts have also been described in Central Africa, Latin America, Middle East and in the independent Republics of the ex-Soviet Union. The clinical features of the disease do not differ from those reported for other viral hepatitides. There have been no cases of chronic hepatitis E reported. Around 20% of women infected during pregnancy develop a severe form of hepatitis which courses to liver failure. Diagnosis of hepatitis is confirmed when antibodies (using ELISA) of the IgM class (acute phase) and/or IgG (infected and cured) are found in the serum. Immunoblot and PCR-RNA may be used as necessary. There is no specific treatment for hepatitis E. Hyperimmune serum has been tried by some authors. Prevention is achieved by following the habitual hygienic and dietetic recommendations valid for diseases transmitted by contaminated water. There is no effective vaccine against the disease.

Disease Outbreaks↗

PubMed1997

[A study on viremia in patients with hepatitis E].

Hepatitis E virus RNA (HEV RNA) was detected in 531 serial serum specimens collected from 62 hospitalized patients with hepatitis E by reverse transcription-nested polymerase chain reaction (RT-nPCR) setting two pairs of primer from open reading frame 1 (ORF1) to understand the process of HEV infection more thoroughly. Results showed that 71 percent of the patients were positive for HEV RNA. Thirty-two of them with 288 serial serum specimens were followed up for the whole process, and 24 cases (75%) were positive for HEV RNA, positive rates declined with the course of the disease and serum HEV RNA lasted for 20.6 days in average. Serum HEV RNA was kept positive in 36 of the 44 patients (81.8%) at the time their serum alanine aminotransferase (ALT) and serum total bilirubin began to lower, and anti-HEV was detected in 39 of them (88.6%). Proportion of HEV viremia and length of it had no direct relationship with serum ALT and levels of total serum bilirubin and anti-HEV.

Hepatitis E↗

PubMedDate not supplied

HBsAg carrier with simultaneous amebic liver abscess and acute hepatitis E.

Hepatitis E virus (HEV) infection and amebiasis are waterborne diseases that are endemic in India. However, their co-occurrence has never been described. We report a patient who presented with fever, jaundice and tender hepatomegaly and on investigation was found to have coexisting acute hepatitis E and amebic liver abscess. Incidentally, he was also an HBsAg carrier.

Adult↗

PubMed2001

Perspectives of vaccination against hepatitis E.

Hepatitis E, an important cause of morbidity and mortality in humans, accounts for more than 50% of acute viral hepatitis in young adults in developing countries with a 20-30% mortality rate among infected pregnant women primarily those in their third trimester. The development of inactivated or live attenuated virus vaccine has been hampered because this virus does not replicate efficiently in cell culture. A vaccine has been developed by an alternative approach through recombinant technology. Preliminary results of the first administration in man conducted in the US at Walter Reed Army Institute of Research indicate the vaccine to be safe and immunogenic and have led to the decision to further evaluate the vaccine in an endemic setting.

Clinical Trials, Phase I as Topic↗

PubMedDate not supplied

Tropical aspects of viral hepatitis. Hepatitis E.

Hepatitis E (HEV) is a faeco-orally transmitted hepatitis virus. It has many features similar to hepatitis A but some differences, notably the high mortality caused by HEV in pregnant women. A vaccine is being developed but at the moment only a clean water supply will reduce the number of cases in areas where the virus is endemic.

Disease Outbreaks↗

PubMed1997

Prevalence of IgG Anti-HEV in Buenos Aires, a Nonendemic Area for Hepatitis E.

Hepatitis E virus (HEV) is the main etiological agent for the enterically transmitted form of non-A, non-B hepatitis (ET-NANB), and is associated with epidemic and sporadic forms of the disease,1 mainly in some developing countries.2 In Argentina, no ET-NANB hepatitis epidemics have been described, and no epidemiological HEV data are known up to this time. The aim of the present study is to evaluate the prevalence of anti-HEV in different groups of the population of Buenos Aires, an area considered to be nonendemic.

Journal Article↗

PubMed2004

[Is endemic hepatitis E infection present in developed countries?--Accumulating information about the hepatitis E virus and hepatitis E infection].

There are several new data on the acute viral hepatitis particularly on infectious non-A-non-C hepatitis viruses. The hepatitis E virus infection was originally thought to be limited only for certain geographic areas and humans. Recently, it has been demonstrated the genetic diversity and worldwide distribution of hepatitis E virus in human population, as well as, the circulation of the virus in many species of animals. It is evident, that hepatitis E virus can spread by fecally contaminated water (waterborne transmission), by meat of infected animals (food-borne transmission), by animal-human contact (zoonotic transmission), and even by transfusion (blood-borne transmission). The frequency of hepatitis E virus infections among the acute hepatitis cases with unknown origin is supposed to be more than 10%. In the differential diagnosis of hepatitis, possible hepatitis E virus infection must be now taken into account even in those areas and countries, like in Hungary, where the infection was previously thought to be non-endemic. To confirm the clinical diagnosis of hepatitis E virus infection, virus specific ELISA and molecular methods are now available. In the near future, a molecular epidemiological study will be organized for the detection of hepatitis E virus in Hungary in collaboration with 9 European countries.--This review covers all aspects of the hepatitis E virus infection including the characteristics and transmission of the etiological agent, the clinical symptoms, its epidemiology, laboratory diagnosis, and some possible control measures.

Developed Countries↗

PubMed1993

Hepatitis E and hepatitis C virus infections among French soldiers with non-A, non-B hepatitis.

Serologic markers of HCV and HEV were investigated in 74 French soldiers with non-A, non-B hepatitis and in 18 patients involved in an outbreak of non-A,non-B hepatitis in Algeria. Moreover, anti-HCV antibodies were detected in 13 patients with non-A,non-B hepatitis of parenteral origin. HEV antibodies were investigated in 61-65% of patients involved in the 2 enterically transmitted outbreaks of non-A,non-B hepatitis observed in Algeria and Chad. The third cluster of non-A,non-B hepatitis observed in French soldiers serving in French Guyana is more likely to be attributed to malaria prophylactic treatment with Amodiaquine than to a viral origin. HCV infection was observed in 93% of acute or chronic cases associated with blood transfusion or parenteral drug abuse. Among acute cases, none of the soldiers who contracted the disease in Africa or in French Guyana was found to be anti-HCV positive compared to 78% of those who contracted the disease in France. HCV infections resulted in chronic hepatitis in 61% of cases.

Adult↗

PubMed2002

Typhoid, hepatitis E, or typhoid and hepatitis E: the cause of fulminant hepatic failure--a diagnostic dilemma.

OBJECTIVE: To report a case of hepatitis E-induced fulminant hepatic failure associated with typhoid fever, diagnosed with the Widal test. DESIGN: Case report. SETTING: Eight-bed medical/surgical intensive care unit of a university hospital. PATIENT: A 15-yr-old, 50-kg male with grade IV hepatic encephalopathy was admitted to the intensive care unit for ventilatory support. On admission to the intensive care unit he had had fever associated with loss of appetite and nausea for 15 days, jaundice for 4 days, and altered sensorium for 2 days. INTERVENTION: He was intubated and kept on elective ventilation. Tracheal aspirate, blood, urine, and stool were sterile. Anti-coma measures were instituted in the form of 20 degrees head elevation; mannitol, lactulose, and ampicillin through a nasogastric tube; and bowel wash. The mainstay of fluid therapy was 20% dextrose. Viral marker was positive for hepatitis E. He showed a favorable recovery but continued to have high-grade fever (39-40 degrees C). On investigation, peripheral blood smear was negative for malarial parasite, and Widal was positive. Fever responded to treatment with Ceftazidime. RESULT: The patient recovered with anti-coma and anti-typhoid therapy. CONCLUSION: In viral hepatitis, fever is usually present in the prodromal phase but subsides before appearance of the icteric phase. In endemic areas, if fever is present in the icteric phase of hepatitis, typhoid also should be considered in the differential diagnosis of fever, even in the absence of positive cultures for Salmonella typhi. The Widal test may be helpful in reaching a diagnosis.

Adolescent↗

PubMed1994

Immunohistochemical study of hepatitis E virus antigen in liver tissues from patients with hepatitis E.

Hepatitis E virus antigen (HEVAg) has been identified in liver tissue of 6 out of 14 patients with hepatitis E using anti-HEV-IgG-horseradish peroxidase (HRP) and direct immunoperoxidase staining methods. HEVAg was found only in the cytoplasm of hepatocytes, but nor in the nuclei. The HEVAg positive hepatocytes were scattered singly, but in a few parts, where the liver damage was severe, the HEVAg positive cells were quite concentrated. We also observed the invasion of lymphocytes into the HEVAg positive hepatocytes. These phenomena suggest that the liver damage may be related to the immune reaction. No HEVAg was found in the liver tissues of stillborn fetus and neonate from woman patients with hepatitis E.

Adult↗

PubMed2004

Transfusion-transmitted hepatitis E caused by apparently indigenous hepatitis E virus strain in Hokkaido, Japan.

BACKGROUND: In industrialized countries, sporadic cases of hepatitis E have been reported in individuals who have never been in an endemic area. Hepatitis E virus (HEV) infection commonly occurs via the fecal-oral route but a potential risk of transfusion transmission route has been suggested. STUDY DESIGN AND METHODS: A 67-year-old Japanese male patient who had never been abroad received a transfusion of blood from 23 voluntary donors and developed acute hepatitis with unknown etiology after transfusion. His blood samples were tested for viral markers of hepatitis viruses. RESULTS: HAV, HBV, HCV, CMV, and EBV were ruled out as causative agents in this case. The patient's blood sample in the acute phase contained HEV RNA as well as IgM and IgG anti-HEV. HEV RNA was also detected in one of the FFP units transfused. The donor had no history of traveling abroad and had a normal ALT level at the time of donation. The PCR products from the patient and the donor showed complete identity for two distinct regions of HEV within open reading frame 1. CONCLUSION: The patient was infected with HEV via transfused blood from a volunteer donor. A potential risk of posttransfusion hepatitis E should be considered even in nonendemic countries.

Adult↗