Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study

H. Blasco-Perrin; R.G. Madden; A. Stanley; Claire Crossan; J.G. Hunter; L. Vine; K. Lane; N. Devooght-Johnson,; C. Mclaughlin; J. Petrik; B. Stableforth; H. Hussaini; M. Phillips; J.M. Mansuy; E. Forrest; J. Izopet; O. Blatchford; L. Scobie; J.M. Peron; H.R. Dalton

doi:10.1111/apt.13309

Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study

H. Blasco-Perrin, R.G. Madden, A. Stanley, Claire Crossan, J.G. Hunter, L. Vine, K. Lane, N. Devooght-Johnson,, C. Mclaughlin, J. Petrik, B. Stableforth, H. Hussaini, M. Phillips, J.M. Mansuy, E. Forrest, J. Izopet, O. Blatchford, L. Scobie, J.M. Peron, H.R. Dalton^*

^*Corresponding author for this work

Biological and Biomedical Sciences

Research output: Contribution to journal › Article

Abstract

Background
In developed countries, hepatitis E is a porcine zoonosis caused by hepatitis E virus (HEV) genotype 3. In developing countries, hepatitis E is mainly caused by genotype 1, and causes increased mortality in patients with pre‐existing chronic liver disease (CLD).

Aim
To determine the role of HEV in patients with decompensated CLD.

Methods
Prospective HEV testing of 343 patients with decompensated CLD at three UK centres and Toulouse France, with follow‐up for 6 months or death. IgG seroprevalence was compared with 911 controls.

Results
11/343 patients (3.2%) had acute hepatitis E infection, and three died. There were no differences in mortality (27% vs. 26%, OR 1.1, 95% CI 0.28–4.1), age (P = 0.9), bilirubin (P = 0.5), alanine aminotransferase (P = 0.06) albumin (P = 0.5) or international normalised ratio (P = 0.6) in patients with and without hepatitis E infection. Five cases were polymerase chain reaction (PCR) positive (genotype 3). Hepatitis E was more common in Toulouse (7.9%) compared to the UK cohort (1.2%, P = 0.003). HEV IgG seroprevalence was higher in Toulouse (OR 17, 95% CI 9.2–30) and Truro (OR 2.5, 95% CI 1.4–4.6) than in Glasgow, but lower in cases, compared to controls (OR 0.59, 95% CI 0.41–0.86).

Conclusions
Hepatitis E occurs in a minority of patients with decompensated chronic liver disease. The mortality is no different to the mortality in patients without hepatitis E infection. The diagnosis can only be established by a combination of serology and PCR, the yield and utility of which vary by geographical location.

Original language	English
Pages (from-to)	574-581
Number of pages	8
Journal	Alimentary Pharmacology and Therapeutics
Volume	42
Issue number	5
Early online date	14 Jul 2015
DOIs	https://doi.org/10.1111/apt.13309
Publication status	Published - Sep 2015

Keywords

liver disease
hepatitis E
HEV testing

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10.1111/apt.13309

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Claire Crossan

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Biological and Biomedical Sciences - Research Fellow

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Blasco-Perrin, H., Madden, R. G., Stanley, A., Crossan, C., Hunter, J. G., Vine, L., Lane, K., Devooght-Johnson, N., Mclaughlin, C., Petrik, J., Stableforth, B., Hussaini, H., Phillips, M., Mansuy, J. M., Forrest, E., Izopet, J., Blatchford, O., Scobie, L., Peron, J. M., & Dalton, H. R. (2015). Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study. Alimentary Pharmacology and Therapeutics, 42(5), 574-581. https://doi.org/10.1111/apt.13309

Blasco-Perrin, H. ; Madden, R.G. ; Stanley, A. ; Crossan, Claire ; Hunter, J.G. ; Vine, L. ; Lane, K. ; Devooght-Johnson, N. ; Mclaughlin, C. ; Petrik, J. ; Stableforth, B. ; Hussaini, H. ; Phillips, M. ; Mansuy, J.M. ; Forrest, E. ; Izopet, J. ; Blatchford, O. ; Scobie, L. ; Peron, J.M. ; Dalton, H.R. / Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study. In: Alimentary Pharmacology and Therapeutics. 2015 ; Vol. 42, No. 5. pp. 574-581.

@article{2cf569e196434be79bcfed29dd1615ef,

title = "Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study",

abstract = "BackgroundIn developed countries, hepatitis E is a porcine zoonosis caused by hepatitis E virus (HEV) genotype 3. In developing countries, hepatitis E is mainly caused by genotype 1, and causes increased mortality in patients with pre‐existing chronic liver disease (CLD).AimTo determine the role of HEV in patients with decompensated CLD.MethodsProspective HEV testing of 343 patients with decompensated CLD at three UK centres and Toulouse France, with follow‐up for 6 months or death. IgG seroprevalence was compared with 911 controls.Results11/343 patients (3.2%) had acute hepatitis E infection, and three died. There were no differences in mortality (27% vs. 26%, OR 1.1, 95% CI 0.28–4.1), age (P = 0.9), bilirubin (P = 0.5), alanine aminotransferase (P = 0.06) albumin (P = 0.5) or international normalised ratio (P = 0.6) in patients with and without hepatitis E infection. Five cases were polymerase chain reaction (PCR) positive (genotype 3). Hepatitis E was more common in Toulouse (7.9%) compared to the UK cohort (1.2%, P = 0.003). HEV IgG seroprevalence was higher in Toulouse (OR 17, 95% CI 9.2–30) and Truro (OR 2.5, 95% CI 1.4–4.6) than in Glasgow, but lower in cases, compared to controls (OR 0.59, 95% CI 0.41–0.86).ConclusionsHepatitis E occurs in a minority of patients with decompensated chronic liver disease. The mortality is no different to the mortality in patients without hepatitis E infection. The diagnosis can only be established by a combination of serology and PCR, the yield and utility of which vary by geographical location.",

keywords = "liver disease, hepatitis E, HEV testing",

author = "H. Blasco-Perrin and R.G. Madden and A. Stanley and Claire Crossan and J.G. Hunter and L. Vine and K. Lane and N. Devooght-Johnson, and C. Mclaughlin and J. Petrik and B. Stableforth and H. Hussaini and M. Phillips and J.M. Mansuy and E. Forrest and J. Izopet and O. Blatchford and L. Scobie and J.M. Peron and H.R. Dalton",

note = "acceptance on webpage 9/3/2020 TM",

year = "2015",

month = sep,

doi = "10.1111/apt.13309",

language = "English",

volume = "42",

pages = "574--581",

journal = "Alimentary Pharmacology and Therapeutics",

issn = "0269-2813",

publisher = "John Wiley & Sons ",

number = "5",

}

Blasco-Perrin, H, Madden, RG, Stanley, A, Crossan, C, Hunter, JG, Vine, L, Lane, K, Devooght-Johnson, N, Mclaughlin, C, Petrik, J, Stableforth, B, Hussaini, H, Phillips, M, Mansuy, JM, Forrest, E, Izopet, J, Blatchford, O, Scobie, L, Peron, JM & Dalton, HR 2015, 'Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study', Alimentary Pharmacology and Therapeutics, vol. 42, no. 5, pp. 574-581. https://doi.org/10.1111/apt.13309

Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study. / Blasco-Perrin, H.; Madden, R.G.; Stanley, A.; Crossan, Claire; Hunter, J.G.; Vine, L.; Lane, K.; Devooght-Johnson, N.; Mclaughlin, C.; Petrik, J.; Stableforth, B.; Hussaini, H.; Phillips, M.; Mansuy, J.M.; Forrest, E.; Izopet, J.; Blatchford, O.; Scobie, L.; Peron, J.M.; Dalton, H.R.

In: Alimentary Pharmacology and Therapeutics, Vol. 42, No. 5, 09.2015, p. 574-581.

Research output: Contribution to journal › Article

TY - JOUR

T1 - Hepatitis E virus in patients with decompensated chronic liver disease: a prospective UK/French study

AU - Blasco-Perrin, H.

AU - Madden, R.G.

AU - Stanley, A.

AU - Crossan, Claire

AU - Hunter, J.G.

AU - Vine, L.

AU - Lane, K.

AU - Devooght-Johnson,, N.

AU - Mclaughlin, C.

AU - Petrik, J.

AU - Stableforth, B.

AU - Hussaini, H.

AU - Phillips, M.

AU - Mansuy, J.M.

AU - Forrest, E.

AU - Izopet, J.

AU - Blatchford, O.

AU - Scobie, L.

AU - Peron, J.M.

AU - Dalton, H.R.

N1 - acceptance on webpage 9/3/2020 TM

PY - 2015/9

Y1 - 2015/9

N2 - BackgroundIn developed countries, hepatitis E is a porcine zoonosis caused by hepatitis E virus (HEV) genotype 3. In developing countries, hepatitis E is mainly caused by genotype 1, and causes increased mortality in patients with pre‐existing chronic liver disease (CLD).AimTo determine the role of HEV in patients with decompensated CLD.MethodsProspective HEV testing of 343 patients with decompensated CLD at three UK centres and Toulouse France, with follow‐up for 6 months or death. IgG seroprevalence was compared with 911 controls.Results11/343 patients (3.2%) had acute hepatitis E infection, and three died. There were no differences in mortality (27% vs. 26%, OR 1.1, 95% CI 0.28–4.1), age (P = 0.9), bilirubin (P = 0.5), alanine aminotransferase (P = 0.06) albumin (P = 0.5) or international normalised ratio (P = 0.6) in patients with and without hepatitis E infection. Five cases were polymerase chain reaction (PCR) positive (genotype 3). Hepatitis E was more common in Toulouse (7.9%) compared to the UK cohort (1.2%, P = 0.003). HEV IgG seroprevalence was higher in Toulouse (OR 17, 95% CI 9.2–30) and Truro (OR 2.5, 95% CI 1.4–4.6) than in Glasgow, but lower in cases, compared to controls (OR 0.59, 95% CI 0.41–0.86).ConclusionsHepatitis E occurs in a minority of patients with decompensated chronic liver disease. The mortality is no different to the mortality in patients without hepatitis E infection. The diagnosis can only be established by a combination of serology and PCR, the yield and utility of which vary by geographical location.

AB - BackgroundIn developed countries, hepatitis E is a porcine zoonosis caused by hepatitis E virus (HEV) genotype 3. In developing countries, hepatitis E is mainly caused by genotype 1, and causes increased mortality in patients with pre‐existing chronic liver disease (CLD).AimTo determine the role of HEV in patients with decompensated CLD.MethodsProspective HEV testing of 343 patients with decompensated CLD at three UK centres and Toulouse France, with follow‐up for 6 months or death. IgG seroprevalence was compared with 911 controls.Results11/343 patients (3.2%) had acute hepatitis E infection, and three died. There were no differences in mortality (27% vs. 26%, OR 1.1, 95% CI 0.28–4.1), age (P = 0.9), bilirubin (P = 0.5), alanine aminotransferase (P = 0.06) albumin (P = 0.5) or international normalised ratio (P = 0.6) in patients with and without hepatitis E infection. Five cases were polymerase chain reaction (PCR) positive (genotype 3). Hepatitis E was more common in Toulouse (7.9%) compared to the UK cohort (1.2%, P = 0.003). HEV IgG seroprevalence was higher in Toulouse (OR 17, 95% CI 9.2–30) and Truro (OR 2.5, 95% CI 1.4–4.6) than in Glasgow, but lower in cases, compared to controls (OR 0.59, 95% CI 0.41–0.86).ConclusionsHepatitis E occurs in a minority of patients with decompensated chronic liver disease. The mortality is no different to the mortality in patients without hepatitis E infection. The diagnosis can only be established by a combination of serology and PCR, the yield and utility of which vary by geographical location.

KW - liver disease

KW - hepatitis E

KW - HEV testing

U2 - 10.1111/apt.13309

DO - 10.1111/apt.13309

M3 - Article

VL - 42

SP - 574

EP - 581

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 5

ER -