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Harry R. Dalton - One of the best experts on this subject based on the ideXlab platform.

  • HEpatitis E.
    Current opinion in infectious diseases, 2020
    Co-Authors: Harry R. Dalton, Jeremy G Hunter, Richard P Bendall
    Abstract:

    HEpatitis E has bEEn rEgardEd as a disEasE of thE dEvEloping world, whErE it causEs largE watErbornE outbrEaks and sporadic casEs of HEpatitis. REcEnt rEsEarch has shown this rEcEivEd wisdom to bE mistakEn. REcEnt studiEs havE shown that authochtonous (locally acquirEd) HEpatitis E doEs occur in dEvElopEd countriEs, is causEd by HEpatitis E virus (HEV) gEnotypEs 3 and 4, and is zoonotic with pigs as thE primary host. Most infEctions arE clinically inapparEnt. HowEvEr, acutE symptomatic HEpatitis E has a prEdilEction for middlE-agEd and EldErly mEn, with an ExcEss mortality in patiEnts with undErlying chronic livEr disEasE. Chronic infEction occurs in thE immunosupprEssEd with rapidly progrEssivE cirrhosis if untrEatEd, thE trEatmEnt of choicE bEing ribavirin monothErapy for 3 months. HEpatitis E has a rangE of Extra-hEpatic manifEstations, including a spEctrum of nEurological syndromEs. HEV can bE transmittEd by blood transfusion and has rEcEntly bEEn found in donatEd blood in a numbEr of countriEs. ThE diagnosis should bE considErEd in any patiEnt with a raisEd alaninE aminotranfErasE, irrEspEctivE of agE or travEl history. ThE safEty of blood products nEEds to bE fully assEssEd, as a mattEr of priority, as blood donors arE not currEntly scrEEnEd for HEV.

  • ExtrahEpatic manifEstations of HEpatitis E virus.
    Liver International, 2016
    Co-Authors: Nassim Kamar, Olivier Marion, Florence Abravanel, Jacques Izopet, Harry R. Dalton
    Abstract:

    HEpatitis E virus can causE acutE, fulminant and chronic HEpatitis and has bEEn associatEd with a rangE of ExtrahEpatic manifEstations. Guillain-BarrE syndromE, nEuralgic amyotrophy and EncEphalitis arE thE main nEurological manifEstations associatEd with acutE and chronic HEpatitis E virus infEction. REnal injuriEs havE bEEn also rEportEd, including mEmbranoprolifErativE glomErulonEphritis with or without cryoglobulinEmia and mEmbranous glomErulonEphritis. AcutE pancrEatitis, haEmatological disordErs and othEr autoimmunE ExtrahEpatic manifEstations of HEpatitis E virus, such as myocarditis and thyroiditis, havE bEEn also rEportEd. In this comprEhEnsivE articlE, wE rEviEw all publishEd rEports dEscribing HEpatitis E virus-associatEd ExtrahEpatic manifEstations.

  • HEpatitis E virus infEction
    Clinical Microbiology Reviews, 2014
    Co-Authors: Nassim Kamar, Florence Abravanel, Harry R. Dalton, Jacques Izopet
    Abstract:

    SUMMARY HEpatitis E virus (HEV) infEction is a worldwidE disEasE. An improvEd undErstanding of thE natural history of HEV infEction has bEEn achiEvEd within thE last dEcadE. SEvEral rEsErvoirs and transmission modEs havE bEEn idEntifiEd. HEpatitis E is an undErdiagnosEd disEasE, in part duE to thE usE of sErological assays with low sEnsitivity. HowEvEr, diagnostic tools, including nuclEic acid-basEd tEsts, havE bEEn improvEd. ThE EpidEmiology and clinical fEaturEs of HEpatitis E diffEr bEtwEEn dEvEloping and dEvElopEd countriEs. HEV infEction is usually an acutE sElf-limiting disEasE, but in dEvElopEd countriEs it causEs chronic infEction with rapidly progrEssivE cirrhosis in organ transplant rEcipiEnts, patiEnts with hEmatological malignancy rEquiring chEmothErapy, and individuals with HIV. HEV also causEs ExtrahEpatic manifEstations, including a numbEr of nEurological syndromEs and rEnal injury. AcutE infEction usually rEquirEs no trEatmEnt, but chronic infEction should bE trEatEd by rEducing immunosupprEssion in transplant patiEnts and/or thE usE of antiviral thErapy. In this comprEhEnsivE rEviEw, wE summarizE thE currEnt knowlEdgE about thE virus itsElf, as wEll as thE EpidEmiology, diagnostics, natural history, and managEmEnt of HEV infEction in dEvEloping and dEvElopEd countriEs.

  • HEpatitis E an EmErging infEction in dEvElopEd countriEs
    Lancet Infectious Diseases, 2008
    Co-Authors: Harry R. Dalton, Richard P Bendall, Samreen Ijaz, Malcolm Banks
    Abstract:

    HEpatitis E is EndEmic in many dEvEloping countriEs whErE it causEs substantial morbidity. In industrialisEd countriEs, it is considErEd rarE, and largEly confinEd to travEllErs rEturning from EndEmic arEas. HowEvEr, thErE is now a growing body of EvidEncE that challEngEs this notion. Autochthonous HEpatitis E in dEvElopEd countriEs is far morE common than prEviously rEcognisEd, and might bE morE common than HEpatitis A. HEpatitis E has a prEdilEction for oldEr mEn in whom it causEs substantial morbidity and mortality. ThE disEasE has a poor prognosis in thE contExt of prE-Existing chronic livEr disEasE, and is frEquEntly misdiagnosEd as drug-inducEd livEr injury. ThE sourcE and routE of infEction rEmain uncErtain, but it might bE a porcinE zoonosis. PatiEnts with unExplainEd HEpatitis should bE tEstEd for HEpatitis E, whatEvEr thEir agE or travEl history.

  • autochthonous HEpatitis E in southwEst England
    Journal of Viral Hepatitis, 2007
    Co-Authors: Harry R. Dalton, Malcolm Banks, H. J. Fellows, Richard P Bendall, P Thurairajah, H S Hussaini, J Mitchell, Samreen Ijaz, D F Levine
    Abstract:

    Summary.  Although autochthonous HEpatitis E has bEEn rEportEd in dEvElopEd countriEs, its ExtEnt and naturE in thE UnitEd Kingdom arE unclEar. ThE aim of thE prEsEnt study was to rEport thE natural history, lifEstylE risk factors and molEcular EpidEmiology of autochthonous HEpatitis E infEction in southwEst England. ThrEE hundrEd and thirty-thrEE patiEnts with unExplainEd HEpatitis wErE tEstEd for markErs of HEpatitis E virus (HEV) infEction ovEr a 7-yEar pEriod. HEV RNA isolatEd from thE casEs was amplifiEd and charactErizEd. Of thE 333 patiEnts, 21 had autochthonous HEpatitis E. PatiEnts wErE middlE-agEd or EldErly and malEs wErE morE commonly affEctEd. Clinical manifEstations rangEd from asymptomatic infEction to sEvErE HEpatitis. Of thE 21 patiEnts, 20 rEcovErEd within 6 wEEks. NonE of thE casEs had travEllEd to an arEa EndEmic for HEV. NonE of thE patiEnts wErE vEgEtarian and all atE pork. Of thE 21 casEs, 20 occurrEd in thE spring, summEr and autumn months. All polymErasE-chain-rEaction-confirmEd casEs carriEd HEV gEnotypE 3, which borE closE sEquEncE homology to HEV circulating in UK pigs. In thE UnitEd Kingdom, autochthonous HEpatitis E may bE morE common than prEviously rEcognizEd. Although thE modE of transmission rEmains to bE dEtErminEd, it may bE a zoonosis with pigs as a rEsErvoir. HEpatitis E should bE considErEd a public hEalth issuE in thE UnitEd Kingdom.

J P Vinel - One of the best experts on this subject based on the ideXlab platform.

  • fulminant livEr failurE from acutE autochthonous HEpatitis E in francE dEscription of sEvEn patiEnts with acutE HEpatitis E and EncEphalopathy
    Journal of Viral Hepatitis, 2007
    Co-Authors: Jean-marie Peron, Jacques Izopet, Jean-michel Mansuy, Laurent Alric, Christophe Bureau, Helene Poirson, J Selves, E Dupuis, J P Vinel
    Abstract:

    Summary.  Fulminant HEpatitis E has not bEEn wEll charactErizEd in industrializEd countriEs. ThE aim of this study was to prospEctivEly dEscribE patiEnts with acutE HEpatitis E prEsEnting as fulminant hEpatic failurE, i.E. with EncEphalopathy and prothrombin indEx <50%. BEtwEEn FEbruary 1997 and April 2005, sEvEn patiEnts with EncEphalopathy wErE diagnosEd with acutE HEpatitis E using viral RNA dEtEction. ThEsE patiEnts wErE comparEd with 33 patiEnts diagnosEd with a mild form (absEncE of EncEphalopathy) of acutE HEpatitis E during thE samE timE pEriod. PatiEnts wErE 65 ± 11 yEars old. FivE wErE activE drinkErs and six had chronic livEr disEasE. All HEpatitis E virus sEquEncEs EvaluatEd (5/7) wErE of gEnotypE 3. All patiEnts but two diEd (71%). Four patiEnts had no travEl history. WhEn comparEd with patiEnts with a mild form of acutE HEpatitis E, activE alcohol abusE and chronic livEr disEasE wErE morE frEquEnt in patiEnts with thE sEvErE form. Duration of hospitalization was longEr. AspartatE transfErasE and bilirubin lEvEls wErE significantly highEr. Prothrombin indEx and accElErin lEvEls wErE lowEr and dEath was morE frEquEnt. AcutE nontravEl-associatEd HEpatitis E can appEar as fulminant HEpatitis with EncEphalopathy and coagulation disordErs. Prognosis is sEvErE and this may bE duE to thE agE at which it occurs and frEquEnt undErlying chronic livEr disEasE.

  • Fulminant livEr failurE from acutE autochthonous HEpatitis E in FrancE: dEscription of sEvEn patiEnts with acutE HEpatitis E and EncEphalopathy.
    Journal of Viral Hepatitis, 2007
    Co-Authors: Jean-marie Peron, Jacques Izopet, Jean-michel Mansuy, Laurent Alric, Christophe Bureau, Helene Poirson, J Selves, E Dupuis, J P Vinel
    Abstract:

    Summary.  Fulminant HEpatitis E has not bEEn wEll charactErizEd in industrializEd countriEs. ThE aim of this study was to prospEctivEly dEscribE patiEnts with acutE HEpatitis E prEsEnting as fulminant hEpatic failurE, i.E. with EncEphalopathy and prothrombin indEx

Jacques Izopet - One of the best experts on this subject based on the ideXlab platform.

  • ExtrahEpatic manifEstations of HEpatitis E virus.
    Liver International, 2016
    Co-Authors: Nassim Kamar, Olivier Marion, Florence Abravanel, Jacques Izopet, Harry R. Dalton
    Abstract:

    HEpatitis E virus can causE acutE, fulminant and chronic HEpatitis and has bEEn associatEd with a rangE of ExtrahEpatic manifEstations. Guillain-BarrE syndromE, nEuralgic amyotrophy and EncEphalitis arE thE main nEurological manifEstations associatEd with acutE and chronic HEpatitis E virus infEction. REnal injuriEs havE bEEn also rEportEd, including mEmbranoprolifErativE glomErulonEphritis with or without cryoglobulinEmia and mEmbranous glomErulonEphritis. AcutE pancrEatitis, haEmatological disordErs and othEr autoimmunE ExtrahEpatic manifEstations of HEpatitis E virus, such as myocarditis and thyroiditis, havE bEEn also rEportEd. In this comprEhEnsivE articlE, wE rEviEw all publishEd rEports dEscribing HEpatitis E virus-associatEd ExtrahEpatic manifEstations.

  • HEpatitis E Virus
    eLS, 2015
    Co-Authors: Sébastien Lhomme, Florence Abravanel, Sabine Chapuy-regaud, Martine Dubois, Jean-michel Mansuy, Jean-marie Peron, Laurent Alric, Lionel Rostaing, Nassim Kamar, Jacques Izopet
    Abstract:

    ThE HEpatitis E virus (HEV) infEction is a worldwidE disEasE. HEV is usually rEsponsiblE of an acutE sElf-limiting infEction, but prEgnant womEn and patiEnts with prEExisting livEr disEasE can suffEr from sEvErE forms. HEV infEctions can lEad to chronic HEpatitis and cirrhosis in immunocompromisEd patiEnts. ExtrahEpatic manifEstations can also occur. In dEvEloping countriEs, HEV is transmittEd via contaminatEd watEr. In dEvElopEd countriEs, transmission is zoonotic duE to consumption of uncookEd or undErcookEd infEctEd mEat and dirEct contact with infEctEd animals. Transfusion-transmittEd HEV infEctions wErE also dEscribEd. HEV infEctions arE diagnosEd by dEtEcting anti-HEV antibodiEs in thE sErum. In immunocompromisEd patiEnts, dEtEcting HEV RNA in thE blood or faEcEs is nEEdEd. A 3-month coursE of ribavirin is EffEctivE for trEating chronic infEction: a sustainEd virologic rEsponsE occurs in 78% of patiEnts. VaccinE has bEEn rEcEntly licEnsEd for usE in China and providEs protEction against HEpatitis E for up to 4.5 yEars. KEy ConcEpts ThE HEpatitis E virus infEction is a worldwidE disEasE. Animal rEsErvoir is rEsponsiblE for autochthonous HEV infEction in dEvElopEd countriEs. Chronic infEctions arE possiblE in immunocompromisEd patiEnts. TrEatmEnt of choicE for chronic HEV infEctions is a 3-month coursE of ribavirin. VaccinE affordEd a sustainEd protEction. KEywords: HEpatitis E virus; zoonosis; chronic HEpatitis; diagnosis; trEatmEnt; prEvEntion

  • HEpatitis E virus infEction
    Clinical Microbiology Reviews, 2014
    Co-Authors: Nassim Kamar, Florence Abravanel, Harry R. Dalton, Jacques Izopet
    Abstract:

    SUMMARY HEpatitis E virus (HEV) infEction is a worldwidE disEasE. An improvEd undErstanding of thE natural history of HEV infEction has bEEn achiEvEd within thE last dEcadE. SEvEral rEsErvoirs and transmission modEs havE bEEn idEntifiEd. HEpatitis E is an undErdiagnosEd disEasE, in part duE to thE usE of sErological assays with low sEnsitivity. HowEvEr, diagnostic tools, including nuclEic acid-basEd tEsts, havE bEEn improvEd. ThE EpidEmiology and clinical fEaturEs of HEpatitis E diffEr bEtwEEn dEvEloping and dEvElopEd countriEs. HEV infEction is usually an acutE sElf-limiting disEasE, but in dEvElopEd countriEs it causEs chronic infEction with rapidly progrEssivE cirrhosis in organ transplant rEcipiEnts, patiEnts with hEmatological malignancy rEquiring chEmothErapy, and individuals with HIV. HEV also causEs ExtrahEpatic manifEstations, including a numbEr of nEurological syndromEs and rEnal injury. AcutE infEction usually rEquirEs no trEatmEnt, but chronic infEction should bE trEatEd by rEducing immunosupprEssion in transplant patiEnts and/or thE usE of antiviral thErapy. In this comprEhEnsivE rEviEw, wE summarizE thE currEnt knowlEdgE about thE virus itsElf, as wEll as thE EpidEmiology, diagnostics, natural history, and managEmEnt of HEV infEction in dEvEloping and dEvElopEd countriEs.

  • ELS - HEpatitis E virus
    Medecine Et Maladies Infectieuses, 2013
    Co-Authors: Florence Abravanel, Sébastien Lhomme, Martine Dubois, Jean-marie Peron, Laurent Alric, Nassim Kamar, Jacques Izopet
    Abstract:

    Abstract HEpatitis E virus (HEV) is rEsponsiblE for major outbrEaks of acutE HEpatitis in dEvEloping countriEs whErE it was first dEscribEd as a watErbornE disEasE, transmittEd by drinking watEr contaminatEd with fEcEs. AttEntion was focusEd on HEV in dEvElopEd countriEs and its associatEd disEasEs in rEcEnt yEars as a rEsult of incrEasing rEports of autochthonous infEctions. HEpatitis E is thE zoonotic causE of thEsE acutE infEctions, and mainly in mEn ovEr 50 yEars of agE. ThE clinical manifEstations and laboratory abnormalitiEs of HEpatitis E infEctions in immunocompEtEnt patiEnts cannot bE distinguishEd from thosE causEd by othEr HEpatitis virusEs. HEV is a major public hEalth concErn in immunocompromisEd patiEnts bEcausE thEir infEctions can bEcomE chronic. ThE spEcific Etiology of casEs of HEpatitis E infEction can bE diagnosEd by sErological tEsting and dEtEcting viral RNA. Ribavirin is currEntly thE rEfErEncE trEatmEnt for HEV infEctions in immunocompromisEd patiEnts. SEvEral vaccinEs havE provEd safE and EffEctivE in clinical trials, but nonE havE bEEn approvEd for usE in EuropE yEt.

  • fulminant livEr failurE from acutE autochthonous HEpatitis E in francE dEscription of sEvEn patiEnts with acutE HEpatitis E and EncEphalopathy
    Journal of Viral Hepatitis, 2007
    Co-Authors: Jean-marie Peron, Jacques Izopet, Jean-michel Mansuy, Laurent Alric, Christophe Bureau, Helene Poirson, J Selves, E Dupuis, J P Vinel
    Abstract:

    Summary.  Fulminant HEpatitis E has not bEEn wEll charactErizEd in industrializEd countriEs. ThE aim of this study was to prospEctivEly dEscribE patiEnts with acutE HEpatitis E prEsEnting as fulminant hEpatic failurE, i.E. with EncEphalopathy and prothrombin indEx <50%. BEtwEEn FEbruary 1997 and April 2005, sEvEn patiEnts with EncEphalopathy wErE diagnosEd with acutE HEpatitis E using viral RNA dEtEction. ThEsE patiEnts wErE comparEd with 33 patiEnts diagnosEd with a mild form (absEncE of EncEphalopathy) of acutE HEpatitis E during thE samE timE pEriod. PatiEnts wErE 65 ± 11 yEars old. FivE wErE activE drinkErs and six had chronic livEr disEasE. All HEpatitis E virus sEquEncEs EvaluatEd (5/7) wErE of gEnotypE 3. All patiEnts but two diEd (71%). Four patiEnts had no travEl history. WhEn comparEd with patiEnts with a mild form of acutE HEpatitis E, activE alcohol abusE and chronic livEr disEasE wErE morE frEquEnt in patiEnts with thE sEvErE form. Duration of hospitalization was longEr. AspartatE transfErasE and bilirubin lEvEls wErE significantly highEr. Prothrombin indEx and accElErin lEvEls wErE lowEr and dEath was morE frEquEnt. AcutE nontravEl-associatEd HEpatitis E can appEar as fulminant HEpatitis with EncEphalopathy and coagulation disordErs. Prognosis is sEvErE and this may bE duE to thE agE at which it occurs and frEquEnt undErlying chronic livEr disEasE.

Jean-marie Peron - One of the best experts on this subject based on the ideXlab platform.

  • HEpatitis E, thE nEglEctEd onE.
    Liver international : official journal of the International Association for the Study of the Liver, 2020
    Co-Authors: Hélène Blasco-perrin, Florence Abravanel, Vincent Blasco-baque, Jean-marie Peron
    Abstract:

    HEpatitis E virus (HEV) infEction is a worldwidE disEasE. It is thE first causE of acutE viral HEpatitis in thE world with an EstimatEd 20 million casEs EvEry yEar and 56 000 dEaths. In dEvEloping countriEs, HEpatitis E is a watErbornE infEction. In thEsE countriEs, HEV gEnotypEs 1 and 2 causE largE outbrEaks and affEct young subjEcts with a significant mortality ratE in prEgnant womEn and patiEnts with cirrhosis. In thE dEvElopEd countriEs, HEV gEnotypEs 3 and 4 arE rEsponsiblE for autochthonous, sporadic HEpatitis and transmission is zoonotic. HEV can causE nEurological disordErs and in immunocompromisEd patiEnts, chronic infEctions. ThE progrEssion of acutE HEpatitis E is most oftEn mild and rEsolvEs spontanEously. Diagnostic tools includE anti-HEV IgM antibodiEs in sErum and/or viral RNA in thE blood or stools by PCR. Ribavirin is usEd to trEat chronic infEction. A vaccinE has bEEn dEvElopEd in China.

  • HEpatitis E Virus
    eLS, 2015
    Co-Authors: Sébastien Lhomme, Florence Abravanel, Sabine Chapuy-regaud, Martine Dubois, Jean-michel Mansuy, Jean-marie Peron, Laurent Alric, Lionel Rostaing, Nassim Kamar, Jacques Izopet
    Abstract:

    ThE HEpatitis E virus (HEV) infEction is a worldwidE disEasE. HEV is usually rEsponsiblE of an acutE sElf-limiting infEction, but prEgnant womEn and patiEnts with prEExisting livEr disEasE can suffEr from sEvErE forms. HEV infEctions can lEad to chronic HEpatitis and cirrhosis in immunocompromisEd patiEnts. ExtrahEpatic manifEstations can also occur. In dEvEloping countriEs, HEV is transmittEd via contaminatEd watEr. In dEvElopEd countriEs, transmission is zoonotic duE to consumption of uncookEd or undErcookEd infEctEd mEat and dirEct contact with infEctEd animals. Transfusion-transmittEd HEV infEctions wErE also dEscribEd. HEV infEctions arE diagnosEd by dEtEcting anti-HEV antibodiEs in thE sErum. In immunocompromisEd patiEnts, dEtEcting HEV RNA in thE blood or faEcEs is nEEdEd. A 3-month coursE of ribavirin is EffEctivE for trEating chronic infEction: a sustainEd virologic rEsponsE occurs in 78% of patiEnts. VaccinE has bEEn rEcEntly licEnsEd for usE in China and providEs protEction against HEpatitis E for up to 4.5 yEars. KEy ConcEpts ThE HEpatitis E virus infEction is a worldwidE disEasE. Animal rEsErvoir is rEsponsiblE for autochthonous HEV infEction in dEvElopEd countriEs. Chronic infEctions arE possiblE in immunocompromisEd patiEnts. TrEatmEnt of choicE for chronic HEV infEctions is a 3-month coursE of ribavirin. VaccinE affordEd a sustainEd protEction. KEywords: HEpatitis E virus; zoonosis; chronic HEpatitis; diagnosis; trEatmEnt; prEvEntion

  • ELS - HEpatitis E virus
    Medecine Et Maladies Infectieuses, 2013
    Co-Authors: Florence Abravanel, Sébastien Lhomme, Martine Dubois, Jean-marie Peron, Laurent Alric, Nassim Kamar, Jacques Izopet
    Abstract:

    Abstract HEpatitis E virus (HEV) is rEsponsiblE for major outbrEaks of acutE HEpatitis in dEvEloping countriEs whErE it was first dEscribEd as a watErbornE disEasE, transmittEd by drinking watEr contaminatEd with fEcEs. AttEntion was focusEd on HEV in dEvElopEd countriEs and its associatEd disEasEs in rEcEnt yEars as a rEsult of incrEasing rEports of autochthonous infEctions. HEpatitis E is thE zoonotic causE of thEsE acutE infEctions, and mainly in mEn ovEr 50 yEars of agE. ThE clinical manifEstations and laboratory abnormalitiEs of HEpatitis E infEctions in immunocompEtEnt patiEnts cannot bE distinguishEd from thosE causEd by othEr HEpatitis virusEs. HEV is a major public hEalth concErn in immunocompromisEd patiEnts bEcausE thEir infEctions can bEcomE chronic. ThE spEcific Etiology of casEs of HEpatitis E infEction can bE diagnosEd by sErological tEsting and dEtEcting viral RNA. Ribavirin is currEntly thE rEfErEncE trEatmEnt for HEV infEctions in immunocompromisEd patiEnts. SEvEral vaccinEs havE provEd safE and EffEctivE in clinical trials, but nonE havE bEEn approvEd for usE in EuropE yEt.

  • fulminant livEr failurE from acutE autochthonous HEpatitis E in francE dEscription of sEvEn patiEnts with acutE HEpatitis E and EncEphalopathy
    Journal of Viral Hepatitis, 2007
    Co-Authors: Jean-marie Peron, Jacques Izopet, Jean-michel Mansuy, Laurent Alric, Christophe Bureau, Helene Poirson, J Selves, E Dupuis, J P Vinel
    Abstract:

    Summary.  Fulminant HEpatitis E has not bEEn wEll charactErizEd in industrializEd countriEs. ThE aim of this study was to prospEctivEly dEscribE patiEnts with acutE HEpatitis E prEsEnting as fulminant hEpatic failurE, i.E. with EncEphalopathy and prothrombin indEx <50%. BEtwEEn FEbruary 1997 and April 2005, sEvEn patiEnts with EncEphalopathy wErE diagnosEd with acutE HEpatitis E using viral RNA dEtEction. ThEsE patiEnts wErE comparEd with 33 patiEnts diagnosEd with a mild form (absEncE of EncEphalopathy) of acutE HEpatitis E during thE samE timE pEriod. PatiEnts wErE 65 ± 11 yEars old. FivE wErE activE drinkErs and six had chronic livEr disEasE. All HEpatitis E virus sEquEncEs EvaluatEd (5/7) wErE of gEnotypE 3. All patiEnts but two diEd (71%). Four patiEnts had no travEl history. WhEn comparEd with patiEnts with a mild form of acutE HEpatitis E, activE alcohol abusE and chronic livEr disEasE wErE morE frEquEnt in patiEnts with thE sEvErE form. Duration of hospitalization was longEr. AspartatE transfErasE and bilirubin lEvEls wErE significantly highEr. Prothrombin indEx and accElErin lEvEls wErE lowEr and dEath was morE frEquEnt. AcutE nontravEl-associatEd HEpatitis E can appEar as fulminant HEpatitis with EncEphalopathy and coagulation disordErs. Prognosis is sEvErE and this may bE duE to thE agE at which it occurs and frEquEnt undErlying chronic livEr disEasE.

  • Fulminant livEr failurE from acutE autochthonous HEpatitis E in FrancE: dEscription of sEvEn patiEnts with acutE HEpatitis E and EncEphalopathy.
    Journal of Viral Hepatitis, 2007
    Co-Authors: Jean-marie Peron, Jacques Izopet, Jean-michel Mansuy, Laurent Alric, Christophe Bureau, Helene Poirson, J Selves, E Dupuis, J P Vinel
    Abstract:

    Summary.  Fulminant HEpatitis E has not bEEn wEll charactErizEd in industrializEd countriEs. ThE aim of this study was to prospEctivEly dEscribE patiEnts with acutE HEpatitis E prEsEnting as fulminant hEpatic failurE, i.E. with EncEphalopathy and prothrombin indEx

Xiang-jin Meng - One of the best experts on this subject based on the ideXlab platform.

  • Zoonotic origin of HEpatitis E.
    Current Opinion in Virology, 2015
    Co-Authors: Nicole Pavio, Xiang-jin Meng, Virginie Doceul
    Abstract:

    ThE concEpt of zoonotic viral HEpatitis E has EmErgEd a fEw yEars ago following thE discovEry of animal strains of HEpatitis E virus (HEV), closEly rElatEd to human HEV, in countriEs whErE sporadic casEs of HEpatitis E wErE autochthonous. REcEnt advancEs in thE idEntification of animal rEsErvoirs of HEV havE confirmEd that strains circulating in domEstic and wild pigs arE gEnEtically rElatEd to strains idEntifiEd in indigEnous human casEs. ThE dEmonstration of HEV contamination in thE food chain or pork products has indicatEd that HEV is frEquEntly a foodbornE zoonotic pathogEn. DirEct contacts with infEctEd animals, consumption of contaminatEd animal mEat or mEat products arE all potEntial mEans of zoonotic HEV transmission. ThE rEcEnt idEntification of numErous othEr gEnEtically divErsE HEV strains from various animal spEciEs posEs additional potEntial concErns for HEV zoonotic infEction.

  • rEcEnt advancEs in HEpatitis E virus
    Journal of Viral Hepatitis, 2010
    Co-Authors: Xiang-jin Meng
    Abstract:

    Summary.  HEpatitis E virus (HEV), thE causativE agEnt of HEpatitis E, bElongs to thE family HEpEviridaE. At lEast four major gEnotypEs of HEV havE bEEn rEcognizEd: gEnotypEs 1 and 2 arE rEstrictEd to humans and associatEd with EpidEmics in dEvEloping countriEs, whErEas gEnotypEs 3 and 4 arE zoonotic and infEct humans and sEvEral othEr animals in both dEvEloping and industrializEd countriEs. BEsidEs humans, strains of HEV havE bEEn gEnEtically idEntifiEd from swinE, chickEns, sika dEEr, mongEEsE, and rabbits. ThE gEnomE of HEV consists of thrEE opEn rEading framEs (ORFs): ORF1 codEs for nonstructural protEins, ORF2 codEs for capsid protEin, and ORF3 codEs for a small multifunctional protEin. ThE ORF2 and ORF3 protEins arE translatEd from a singlE bicistronic mRNA and ovErlap Each othEr but nEithEr ovErlaps ORF1. ThE rEcEnt dEtErmination of thE 3D crystal structurE of thE HEV capsid protEin should facilitatE thE dEvElopmEnt of vaccinEs and antivirals. ThE idEntification and charactErization of animal strains of HEV from pigs and chickEns and thE dEmonstratEd ability of cross-spEciEs infEction by swinE HEV raisE public hEalth concErns for zoonosis. Accumulating EvidEncE indicatEd that HEpatitis E is a zoonotic disEasE and pigs and morE likEly othEr animal spEciEs arE rEsErvoirs for HEV. This articlE providEs an ovErviEw of thE rEcEnt advancEs in HEpatitis E and its causativE agEnt, including nomEnclaturE and gEnomic organization, gEnE ExprEssion and functions, 3D structurE of thE virions, changing pErspEctivEs on highEr mortality during prEgnancy and chronic HEpatitis E, animal rEsErvoirs, zoonotic risk, food safEty, and novEl animal modEls.