Autochthonous hepatitis e in Southwest England: Natural history, complications and seasonal variation, and hepatitis e virus IgG seroprevalence in blood donors, the elderly and patients with chronic liver disease

Harry R. Dalton, William Stableforth, Prem Thurairajah, Simon Hazeldine, Rene Remnarace, Warshow Usama, Liz Farrington, Noor Hamad, Cyril Sieberhagen, Vic Ellis, Jonathan Mitchell, S. Hyder Hussaini, Malcolm Banks, Samreen Ijaz, Richard P. Bendall

    Research output: Contribution to journalArticlepeer-review

    216 Citations (Scopus)

    Abstract

    AIMS: To report the natural history of autochthonous hepatitis E and hepatitis E virus (HEV) IgG seroprevalence in Southwest England. Methods: Patients with unexplained hepatitis were tested for hepatitis E and cases followed until recovery or death. Five hundred blood donors, 336 individuals over the age of 60 years and 126 patients with chronic liver disease were tested for HEV IgG. Results: Forty cases of autochthonous hepatitis E (genotype 3) were identified. Hepatitis E was anicteric in 25% of cases and usually caused a self-limiting hepatitis predominantly in elderly Caucasian males. Six of 40 had a significant complication and three patients died, two of who had previously undiagnosed cirrhosis. Hepatitis E shows a seasonal variation with peaks in the spring and summer and no cases in November and December. HEV IgG prevalence increases with age, is more common in men and is 16% in blood donors, 13% in patients with chronic liver disease and 25% in individuals over 60 years. Conclusion: Autochthonous hepatitis E is more common than previously recognized, and should be considered in the differential diagnosis in patients with hepatitis, whatever their age or travel history. It carries a significant morbidity and when seen in the context of chronic liver disease carries an adverse prognosis.

    Original languageEnglish
    Pages (from-to)784-790
    Number of pages7
    JournalEuropean Journal of Gastroenterology and Hepatology
    Volume20
    Issue number8
    DOIs
    Publication statusPublished - Aug 2008

    Keywords

    • Autochthonous
    • Hepatitis E
    • Zoonosis

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