Locally acquired hepatitis E virus in Marche Italy: Clinical/laboratory features and outcome.
Acute Kidney Injury
/ epidemiology
Acute-On-Chronic Liver Failure
/ epidemiology
Adult
Aged
Female
Genotype
Hepatitis E
/ epidemiology
Hepatitis E virus
/ genetics
Humans
Immunocompromised Host
Italy
/ epidemiology
Liver Cirrhosis
/ epidemiology
Logistic Models
Male
Middle Aged
Retrospective Studies
Risk Factors
Acute on-chronic liver failure
Chronic liver disease
Diabetes
HEV
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
20
08
2019
revised:
23
10
2019
accepted:
18
11
2019
pubmed:
26
12
2019
medline:
8
5
2021
entrez:
26
12
2019
Statut:
ppublish
Résumé
Hepatitis E Virus is endemic in Europe with increasing numbers of cases in recent years, also in Italy where this phenomenon has hitherto been modest. The aim of this study was to document the clinical features/natural history of locally acquired hepatitis E in our territory and explore factors which determine adverse outcome. Retrospective study of patients with locally-acquired HEV (hepatitis E virus) in Marche, Italy (2011-2019). 1189 patients were tested for HEV with 89 confirmed cases. 81 (6.8%) had locally acquired infection; 54 (66%) were male (mean age 55.5 years) and 32 (39.5%) had active co-morbidities. 41 cases were viraemic (all HEV-3 (HEV genotype 1,2,3,4)); acute infection was found in 79 and chronic infection in 2. Forty-five cases (55%) required admission to hospital, for a total of 785 days. 4 patients developed acute on-chronic liver failure, 6 developed acute kidney injury and 8 died: all had active comorbidities. Univariate analysis showed that bilirubin, INR, immunosuppression, cirrhosis and diabetes were associated with death. On multivariant analysis the only predictor of death was the presence of diabetes (p = 0.04). Hepatitis E in Marche Italy is mostly locally acquired and caused by HEV-3 that impacts on the morbidity and mortality particularly for fragile patients.
Sections du résumé
BACKGROUND AND AIMS
Hepatitis E Virus is endemic in Europe with increasing numbers of cases in recent years, also in Italy where this phenomenon has hitherto been modest. The aim of this study was to document the clinical features/natural history of locally acquired hepatitis E in our territory and explore factors which determine adverse outcome.
METHODS
Retrospective study of patients with locally-acquired HEV (hepatitis E virus) in Marche, Italy (2011-2019).
RESULTS
1189 patients were tested for HEV with 89 confirmed cases. 81 (6.8%) had locally acquired infection; 54 (66%) were male (mean age 55.5 years) and 32 (39.5%) had active co-morbidities. 41 cases were viraemic (all HEV-3 (HEV genotype 1,2,3,4)); acute infection was found in 79 and chronic infection in 2. Forty-five cases (55%) required admission to hospital, for a total of 785 days. 4 patients developed acute on-chronic liver failure, 6 developed acute kidney injury and 8 died: all had active comorbidities. Univariate analysis showed that bilirubin, INR, immunosuppression, cirrhosis and diabetes were associated with death. On multivariant analysis the only predictor of death was the presence of diabetes (p = 0.04).
CONCLUSIONS
Hepatitis E in Marche Italy is mostly locally acquired and caused by HEV-3 that impacts on the morbidity and mortality particularly for fragile patients.
Identifiants
pubmed: 31874836
pii: S1590-8658(19)30924-7
doi: 10.1016/j.dld.2019.11.015
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
434-439Informations de copyright
Copyright © 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.