title: Hepatitis E in a region of Italy: An emerging autochthonous infection?
abstract: BACKGROUND
  Recent data showed an increasing number of "autochthonous" cases of hepatitis E in Italy.
  
  
  OBJECTIVE
  Analysing cases of acute hepatitis E to define frequency, clinical features, prognosis and risk factors.
  
  
  METHODS
  We considered all the patients admitted to our Regional Hospital between August 2011 and September 2014, with a diagnosis of acute hepatitis; serological screening for hepatitis B, C and A viruses was performed; in the event of negative results, sera were tested for cytomegalovirus, Epstein-Barr and hepatitis E viruses.
  
  
  RESULTS
  Among 200 patients, 66 were affected by viral infection. IgM anti-HEV was detected in 14 patients with a predominance of males (79%) with a mean age of 55. Genotype 3 of HEV was found in 8 patients. Only one patient died of acute on chronic liver failure; all others evolved favourably towards clinical remission within two months from clinical onset. Thirteen patients had had local exposure to infection and 9 reported the consumption of raw or undercooked locally produced pork.
  
  
  CONCLUSIONS
  The incidence of HEV in our cohort of patients with acute viral hepatitis is high (about 20% per year). In over 85% an autochthonous exposure to infection could be recognised, with a clear link with food habits.
authors.affiliation: Department of Gastroenterology and Transplants, Clinic of Gastroenterology, Hospital of Ancona, Università Politecnica delle Marche, Italy. Electronic address: giutar77@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tarantino
authors.affiliation: Department of Biomedical Sciences and Public Health, Virology, Hospital of Ancona, Università Politecnica delle Marche, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Bagnarelli
authors.affiliation: Department of Gastroenterology and Transplants, Clinic of Gastroenterology, Hospital of Ancona, Università Politecnica delle Marche, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Marzioni
authors.affiliation: Department of Biomedical Sciences and Public Health, Virology, Hospital of Ancona, Università Politecnica delle Marche, Italy.
authors.forename: Katia
authors.initials: K
authors.lastname: Marinelli
authors.affiliation: Department of Gastroenterology and Transplants, Clinic of Gastroenterology, Hospital of Ancona, Università Politecnica delle Marche, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Surace
authors.affiliation: Department of Gastroenterology and Transplants, Clinic of Gastroenterology, Hospital of Ancona, Università Politecnica delle Marche, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Traini
authors.affiliation: Department of Gastroenterology and Transplants, Clinic of Gastroenterology, Hospital of Ancona, Università Politecnica delle Marche, Italy.
authors.forename: Gianluca Svegliati
authors.initials: GS
authors.lastname: Baroni
authors.affiliation: Department of Biomedical Sciences and Public Health, Virology, Hospital of Ancona, Università Politecnica delle Marche, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Menzo
authors.affiliation: Department of Gastroenterology and Transplants, Clinic of Gastroenterology, Hospital of Ancona, Università Politecnica delle Marche, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Benedetti
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005517:Foodborne Diseases / Q000453:epidemiology*; D005838:Genotype; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000453:epidemiology*; D016752:Hepatitis E virus / Q000235:genetics; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000069466:Red Meat; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D006508:Hepatitis Antibodies; D007075:Immunoglobulin M
keywords: Acute hepatitis; HEV; Liver failure; Zoonosis