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Related Concept Videos

Hepatitis01:25

Hepatitis

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Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver.
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Viral Hepatitis I: Introduction01:28

Viral Hepatitis I: Introduction

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Viral hepatitis is an inflammatory condition of the liver caused by infection with hepatotropic viruses, most commonly hepatitis A, B, C, D, and E. Despite variations in structure and transmission, all viruses mentioned infect hepatocytes and provoke immune responses that can hinder liver function. Additionally, some non-hepatotropic viruses can also lead to hepatic inflammation.Hepatitis A VirusHepatitis A virus (HAV) is transmitted through the fecal–oral route, typically by ingestion...
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Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
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Jaundice01:25

Jaundice

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Jaundice, or icterus, is the yellow discoloration of the skin, sclerae, and mucous membranes. It happens when plasma bilirubin levels rise above 2.5-3 mg/dL, leading to bilirubin deposition in tissue.Bilirubin is a byproduct of hemoglobin degradation. In macrophages, hemoglobin breaks down into globin and heme. Globin is converted into amino acids, while heme is turned into biliverdin by heme oxygenase, which is then reduced to unconjugated bilirubin by biliverdin reductase.Unconjugated...
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Hepatitis E in Germany--an under-reported infectious disease.

Sven Pischke1, Patrick Behrendt, Claus-Thomas Bock

  • 1Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hanover, German Centre for Infection Research, Hanover, TWINCORE Institute for Experimental Infection Research, Hanover, Health Care Center at the University Medical Center Hamburg-Eppendorf, Robert Koch Institute Berlin, Consiliary Laboratory for Hepatitis A and Hepatitis E, Institute for Medical Microbiology and Hygiene, University Hospital Regensburg, Regensburg.

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Summary

Hepatitis E virus (HEV) infection is common in Germany, often asymptomatic. Severe cases and chronic infections in immunosuppressed individuals require consideration, with ribavirin showing efficacy in treatment.

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Virology

Background:

  • Hepatitis E virus (HEV) infection prevalence in Germany is higher than previously estimated, affecting at least 17% of the population.
  • Reported HEV infections to the Robert Koch Institute in 2013 were fewer than 500, contrasting with the high infection rate.

Purpose of the Study:

  • To review the epidemiology, transmission, clinical manifestations, and treatment of Hepatitis E virus infections.
  • To highlight the importance of considering HEV in differential diagnoses for liver and neurological conditions.

Main Methods:

  • A selective literature search was conducted using PubMed to retrieve pertinent studies.
  • Review of existing literature on Hepatitis E virus infections.

Main Results:

  • Hepatitis E is primarily acquired domestically in Germany through consumption of undercooked pork; imported cases are rare.
  • While most HEV infections are asymptomatic and self-limiting, severe outcomes like acute liver failure and chronic infection in immunosuppressed individuals can occur.
  • Extrahepatic manifestations, including Guillain-Barré syndrome, are associated with HEV, and ribavirin demonstrated activity against HEV in case series.

Conclusions:

  • Hepatitis E should be considered in the differential diagnosis of elevated liver enzymes and unexplained systemic or neurological symptoms.
  • HEV infection is typically self-limiting but can be severe in immunosuppressed patients.
  • Ribavirin is a potential antiviral treatment option for both acute and chronic HEV infections, particularly in severe or chronic cases.