Hepatitis E autochthonous infection in chronic liver disease.
Hepatitis E virus is endemic in many parts of the developing world and causes a self-limiting hepatitis in young adults, except in pregnant women and patients with chronic liver disease, where the mortality is high. Locally acquired hepatitis E is increasingly recognized in the developed world. It is caused by hepatitis E virus genotype 3, affects the middle-aged and the elderly, and may be a zoonotic infection from pigs. We present a case of locally acquired hepatitis E infection in a patient with previously undiagnosed cirrhosis, which resulted in subacute liver failure and death. We describe our attempt to trace this infection to a free-range pig farm adjacent to the patient's place of employment. Hepatitis E infection should be considered in the differential diagnosis in patients with decompensated chronic liver disease whatever their age or travel history. When found, the prognosis may be poor.
Lockwood
Gabrielle L
GL
Cornwall Gastrointestinal Unit, Royal Cornwall Hospital Trust, Truro, Cornwall, UK.
Fernandez-Barredo
Salceda
S
Bendall
Richard
R
Banks
Malcolm
M
Ijaz
Samreen
S
Dalton
Harry R
HR
D000818:Animals; D002908:Chronic Disease; D017809:Fatal Outcome; D016751:Hepatitis E / Q000150:complications / Q000175:diagnosis* / Q000635:transmission / Q000821:virology; D016752:Hepatitis E virus / Q000145:classification / Q000235:genetics; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D034421:Sus scrofa; D015047:Zoonoses / Q000635:transmission