Clinical and virological profile of locally acquired acute hepatitis E in South Bulgaria

Authors

  • Radka Komitova Department of Infectious Diseases, Parasitology and Tropical Medicine, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria https://orcid.org/0000-0002-4374-8815
  • Ani Kevorkyan Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
  • Elitsa Golkocheva-Markova National Reference Laboratory “Hepatitis Viruses”, Department of Virology, National Center of Infectious and parasitic Diseases, Sofia, Bulgaria https://orcid.org/0000-0002-3462-866X
  • Mariya Atanasova Department of Microbiology and Immunology “Prof. Dr. Elissay Yanev”, Faculty of Medicine, Medical University of Plovdiv, Bulgaria https://orcid.org/0000-0001-8376-8370
  • Vanya Rangelova Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
  • Ralitsa Raycheva Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria https://orcid.org/0000-0002-6417-5681
  • Chyidem Ismailova National Reference Laboratory “Hepatitis Viruses”, Department of Virology, National Center of Infectious and parasitic Diseases, Sofia, Bulgaria
  • Asya Stoyanova National Reference Laboratory of Enteroviruses, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
  • Tencho Tenev National Reference Laboratory “Hepatitis Viruses”, Department of Virology, National Center of Infectious and parasitic Diseases, Sofia, Bulgaria

DOI:

https://doi.org/10.3855/jidc.18341

Keywords:

hepatitis E virus, chronic liver disease, zoonosis, hepatitis B virus, fulminant hepatitis, Bulgaria

Abstract

Introduction: Acute hepatitis E virus (HEV) infection is recognized as a zoonosis in several European countries. We describe the characteristics and outcomes of locally acquired acute HEV hepatitis.

Methodology: A prospective study was conducted among adult patients with acute HEV hepatitis at the University Hospital in Plovdiv, South Bulgaria between January 2020 and May 2022. An acute HEV infection case was a patient with acute hepatitis and laboratory-confirmed anti-HEV IgM antibodies and/or HEV RNA in serum. Demographic data, clinical manifestations, laboratory test results, and outcomes were recorded.

Results: A total of 46 patients were selected. Median age of 65 years (interquartile range [IQR] 50.8-74.3). 28 (60.87%) were male. 22 (47.83%) had comorbidities such as diabetes (15), liver cirrhosis (3), hepatitis B virus infection (2), and malignancies (2). Of the 46, 18 (39.13%) patients were viremic and, HEV genotype 3 was detected. The median (IQR) serum alanine aminotransferase, aspartate aminotransferase, bilirubin, platelet, and international normalized ratio levels were 992 (495.8-1714.3) U/L, 715 (262.5-1259.3) U/L, 204 (132.3-235.5) µmol/L, 204 (132.3-235.5) ×109 L, and 1.0 (0.89-1.19), respectively. Six patients with underlying liver diseases had severe hepatitis. A young patient with osteoarthritis progressed to acute liver failure and died. The persistent HEV infection was ruled out in 2 malignant patients who tested HEV RNA negative three months after discharge.

Conclusions: Acute HEV hepatitis is a diagnosis to consider after excluding other causes of acute viral hepatitis. A diagnostic workup should include timely testing for HEV to identify the most vulnerable to severe consequences.

Author Biography

Mariya Atanasova, Department of Microbiology and Immunology “Prof. Dr. Elissay Yanev”, Faculty of Medicine, Medical University of Plovdiv, Bulgaria

Laboratory of Virology, St George University Hospital, Plovdiv, Bulgaria

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Published

2024-01-31

How to Cite

1.
Komitova R, Kevorkyan A, Golkocheva-Markova E, Atanasova M, Rangelova V, Raycheva R, Ismailova C, Stoyanova A, Tenev T (2024) Clinical and virological profile of locally acquired acute hepatitis E in South Bulgaria. J Infect Dev Ctries 18:136–144. doi: 10.3855/jidc.18341

Issue

Vol. 18 No. 01: January 2024

Section

Original Articles

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Copyright (c) 2024 Radka Komitova, Ani Kevorkyan, Elitsa Golkocheva-Markova3, Mariya Atanasova, Vanya Rangelova, Ralitsa Raycheva, Chyidem Ismailova, Asya Stoyanova, Tencho Tenev

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