Acute hepatitis E in Montenegro: epidemiology, clinical and laboratory features.
OBJECTIVE
To evaluate the incidence, demographic, clinical and laboratory characteristics of patients with acute viral hepatitis E in Montenegro.


METHODS
A total of 400 patients with acute viral hepatitis from January 1st, 2000 to December 31st, 2007 were enrolled in the study. Serological tests for hepatitis A, B, C, D, and E viruses, Epstein-Barr virus, cytomegalovirus, and herpes simplex viruses were performed. Standard laboratory tests for liver function were analyzed. The results are presented as absolute numbers, mean +/- SD, range of values, and percent. A P value < 0.05 was considered significant.


RESULTS
Twenty-four (6%) patients had clinically and/or serologically confirmed acute hepatitis E. The mean age of the patients was 25 +/- 6 years; 62.5% were males. The majority of the patients (66%) belonged to the 20 to 40 yrs age group (P < 0.05). Seven patients were asymptomatic. Foremost symptoms were loss of appetite (100%), fatigue (94%) and vomiting (75%). The most frequent clinical sign was mild to moderate liver enlargement (94%). Jaundice had 12/17 symptomatic patients. Elevation of alanine aminotransferase was found in 19 patients including two patients without symptoms. The enzyme, gamma glutamyltranspeptidase was increased in all patients.


CONCLUSIONS
Acute hepatitis E in Montenegro emerges as an autochthonous infection with a low incidence. Sub-clinical and anicteric infections may occur. Elevation of gamma glutamyltranspeptidase is an important parameter of the biochemical profile of the disease.
Terzic
Dragica
D
Clinic for Infectious Diseases, Clinical Centre of Montenegro, Podgorica, Montenegro.
Dupanovic
Brankica
B
Mugosa
Boban
B
Draskovic
Nenad
N
Svirtlih
Neda
N
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D002648:Child; D005221:Fatigue / Q000209:etiology; D005260:Female; D016751:Hepatitis E / Q000150:complications / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D054548:Montenegro / Q000453:epidemiology; D012189:Retrospective Studies; D014839:Vomiting / Q000209:etiology; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000378:metabolism
D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase