High Incidence of Acute Liver Failure among Patients in Egypt Coinfected with Hepatitis A and Hepatitis E Viruses

被引:6
作者
El-Mokhtar, Mohamed A. [1 ,2 ]
Elkhawaga, Amal A. [1 ]
Ahmed, Mona Sedky Hussein [3 ]
El-Sabaa, Ehsan M. W. [4 ]
Mosa, Aliaa A. [5 ]
Abdelmohsen, Ahmed Shawkat [6 ]
Moussa, Abdelmajeed M. [7 ]
Salama, Eman H. [8 ]
Aboulfotuh, Sahar [8 ]
Ashmawy, Ahmed M. [9 ]
Seddik, Ahmed Ismail [10 ]
Sayed, Ibrahim M. [1 ]
Ramadan, Haidi Karam-Allah [6 ]
机构
[1] Assiut Univ, Fac Med, Dept Med Microbiol & Immunol, Assiut 71515, Egypt
[2] Lebanese Amer Univ, Gilbert & Rose Marie Chagoury Sch Med, POB 36, Byblos, Lebanon
[3] Assiut Univ, Mol Biol Res & Studies Inst MBRSI, Lab Mol Cell Biol, Assiut 71515, Egypt
[4] Assiut Univ, Fac Pharm, Microbiol & Immunol Dept, Assiut 71515, Egypt
[5] Assiut Univ, Fac Med, Dept Med Biochem, Assiut 71515, Egypt
[6] Assiut Univ, Fac Med, Dept Trop Med & Gastroenterol, Assiut 71515, Egypt
[7] Aswan Univ, Fac Med, Dept Trop Med & Gastroenterol, Aswan 81528, Egypt
[8] Sohag Univ, Fac Med, Dept Clin Pathol, Sohag 82524, Egypt
[9] Assiut Univ, Fac Med, Dept Internal Med, Gastroenterol & Hepatol Unit, Assiut 71515, Egypt
[10] Aswan Univ, Fac Med, Pediat Dept, Aswan 81528, Egypt
关键词
HAV; HEV; co-infection; outcome; acute liver failure; ACUTE VIRAL-HEPATITIS; ACUTE SPORADIC HEPATITIS; INFECTIOUS-HEPATITIS; UNITED-STATES; CHILDREN; OUTBREAK; PREVALENCE; HEV; SEROPREVALENCE; INACTIVATION;
D O I
10.3390/microorganisms11122898
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Hepatitis A virus (HAV) and Hepatitis E virus (HEV) are transmitted through the fecal-oral route. HAV outbreaks and one HEV outbreak have been reported in Egypt. However, the impact of HAV-HEV co-infection is not known. In this study, we assessed HEV markers in acute HAV-infected patients (n = 57) enrolled in Assiut University hospitals. We found that 36.8% of HAV-infected patients were also positive for HEV markers (anti-HEV IgM and HEV RNA), while 63.2% of the patients were HAV mono-infected. Demographic and clinical criteria were comparable in both HAV mono-infected patients and HAV-HEV co-infected patients. Although liver enzymes were not significantly different between the two groups, liver transaminases were higher in the co-infected patients. Six patients developed acute liver failure (ALF); five of them were HAV-HEV-co-infected patients. The relative risk of ALF development was 8.5 times higher in HAV-HEV co-infection compared to mono-infection. Three cases of ALF caused by HAV-HEV co-infection were reported in children (below 18 years) and two cases were reported in adults. All patients developed jaundice, coagulopathy, and encephalopathy; all were living in rural communities. In conclusion: HAV-HEV co-infection can be complicated by ALF. The risk of ALF development in HAV-infected patients is higher when coinfection with HEV is present.
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页数:12
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