Hepatitis E virus is responsible for decompensation of chronic liver disease in an endemic region.
BACKGROUND
Hepatitis A virus infection in patients with previously stable chronic liver disease is associated with liver decompensation. Whether infection with hepatitis E virus (HEV) also does so is not known.


METHODS
We studied 32 patients with decompensated liver disease and definite evidence of underlying cirrhosis for evidence of recent HEV infection.


RESULTS
Of 32 patients, 14 (44%) had detectable IgM anti-HEV in their serum. In comparison, only 3 of 48 (6%) patients with stable cirrhosis and no recent decompensation had such antibodies (p<0.0001). Of the 14 patients with evidence of recent HEV infection, 11 had history of prodrome. The etiology of cirrhosis in these patients was: hepatitis B 6, hepatitis C 2, both hepatitis B and C 2, Wilson's disease 1, autoimmune 1 and cryptogenic 2. Two of these 14 patients died. Twelve patients survived, as compared to 9 of 18 patients without evidence of recent HEV infection (p<0.01).


CONCLUSIONS
HEV infection is a frequent cause of decompensation in patients with liver cirrhosis in HEV-endemic regions.
Kumar
Arvind
A
Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226 014.
Aggarwal
Rakesh
R
Naik
S R
SR
Saraswat
Vivek
V
Ghoshal
Uday C
UC
Naik
Sita
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002908:Chronic Disease; D018450:Disease Progression; D019353:Endemic Diseases; D005260:Female; D005500:Follow-Up Studies; D016751:Hepatitis E / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000453:epidemiology; D017114:Liver Failure, Acute / Q000175:diagnosis* / Q000453:epidemiology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015163:Superinfection / Q000175:diagnosis* / Q000453:epidemiology; D015996:Survival Rate