Hepatitis E makes severe impact on CLD

liver411

Journal of Gastroenterology and Hepatology
Volume 19 Issue 2 Page 134  - February 2004
doi:10.1111/j.1440-1746.2004.03188.x


HEPATOLOGY
[B]Hepatitis E superinfection produces severe decompensation in patients with
chronic liver disease[/B]

JEYAMANI RAMACHANDRAN*, CE EAPEN*, GAGANDEEP KANG*, PRIYA ABRAHAM, DARIUS DJ
HUBERT, GEORGE KURIAN*, JULIE HEPHZIBAH*, ASHIS MUKHOPADHYA* AND GEORGE M
CHANDY*

Abstract

Background and Aims: The adverse effect of acute hepatitis A in chronic
liver disease is well known. The outcome of acute hepatitis E in chronic
liver disease has not been extensively studied. The present study aimed to
examine the clinical profile and outcome of patients with chronic liver
disease and hepatitis E virus (HEV) superinfection, and the seroprevalence
of hepatitis A and E infections in patients with chronic liver disease and
controls in India.

Methods: A retrospective study of patients with chronic liver disease and
acute icteric hepatitis E was performed. Acute hepatitis E was diagnosed by
immunoglobulin (Ig)M ELISA. Seroprevalence studies were carried out using
IgG ELISA in 100 patients with chronic liver disease and 79 age- and
sex-matched controls.

Results: From June 2001 to December 2002, nine patients with chronic liver
disease were found to have superinfection with HEV. Out of these, six
patients died of advanced liver failure. The etiology of liver disease was
Wilson's disease in six, hepatitis B virus in one, autoimmune in one and
cryptogenic in one case. The seroprevalence of hepatitis A was 99 and 100%
and 56 and 21% for HEV in cases and controls, respectively.

Conclusions: Acute HEV in patients with chronic liver disease has a grave
prognosis. Wilson's disease was the most common cause of chronic liver
disease complicated by acute HEV. Seroprevalence studies showed that 44% of
patients with chronic liver disease were at risk of developing hepatitis E.
Hepatitis E vaccine, when available, is indicated for use in this group.
Accepted for publication 11 May 2003.


Affiliations

*Departments of Gastrointestinal Sciences and
Clinical Virology, Christian Medical College, Vellore, Tamilnadu, India


Correspondence

Dr Ramachandran Jeyamani, Department of Gastrointestinal Sciences, Christian
Medical College, Vellore 632004, Tamilnadu, India. Email: [email protected]
To cite this article
RAMACHANDRAN, JEYAMANI, EAPEN, CE, KANG, GAGANDEEP, ABRAHAM, PRIYA, HUBERT,
DARIUS DJ, KURIAN, GEORGE, HEPHZIBAH, JULIE, MUKHOPADHYA, ASHIS & CHANDY,
GEORGE M (2004)
Hepatitis E superinfection produces severe decompensation in patients with
chronic liver disease.
Journal of Gastroenterology and Hepatology 19 (2), 134-138.
doi: 10.1111/
j.1440-1746.2004.03188.x