title: Comparison of autochthonous and imported cases of hepatitis A or hepatitis E.
abstract: BACKGROUND
  Hepatitis A and hepatitis E are not limited to tropical countries but are also present in industrialized countries. Both infections share similar clinical features. There is no comparative study evaluating the clinical parameters of autochthonous and imported hepatitis A virus and hepatitis E virus infections.
  
  
  OBJECTIVE
  The aim of this study was to determine differences between autochthonous and imported hepatitis A virus (HAV) and hepatitis E virus (HEV) infections.
  
  
  METHODS
  Medical charts of all patients at our center with acute HAV and HEV infections were analyzed retrospectively (n = 50, study period 01/2009 - 08/2013).
  
  
  RESULTS
  Peak bilirubin (median 8.6 vs. 4.4 mg/dL, p = 0.008) and ALT levels (median 2998 vs. 1666 IU/mL, p = 0.04) were higher in patients with hepatitis A compared to hepatitis E. In comparison to autochthones hepatitis E cases, patients with imported infections had significantly higher peak values for AST, ALT, bilirubin and INR (p = 0.009, p = 0.002, p = 0.04 and p = 0.049, respectively). In HAV infection, AST levels tended to be higher in imported infections (p = 0.08).
  
  
  CONCLUSIONS
  (i) It is not possible to differentiate certainly between acute HAV and HEV infections by clinical or biochemical parameters, however, HAV infections might be associated with more cholestasis and higher ALT values. (ii) Imported HEV infections are associated with higher transaminases, INR and bilirubin levels compared to autochthonous cases and (iii) imported HAV infections tend to be associated with higher transaminases in comparison to autochthonous cases.
authors.affiliation: First Medical Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Hartl
authors.affiliation: First Medical Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Kreuels
authors.affiliation: Clinical Mikrobiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Polywka
authors.affiliation: First Medical Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Addo
authors.affiliation: Clinical Mikrobiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Luethgehetmann
authors.affiliation: First Medical Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Dandri
authors.affiliation: First Medical Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Dammermann
authors.affiliation: First Medical Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Sterneck
authors.affiliation: First Medical Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: A W
authors.initials: AW
authors.lastname: Lohse
authors.affiliation: Outpatient Clinic for Livertransplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Pischke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D004641:Emigration and Immigration; D005260:Female; D005858:Germany; D006506:Hepatitis A / Q000097:blood / Q000175:diagnosis*; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D000637:Transaminases / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D000637:Transaminases; D001663:Bilirubin