Low mortality despite temporary liver dysfunction in severe courses of acute hepatitis E

Area of Science:

• Hepatology
• Virology
• Epidemiology

Background:

• Hepatitis E virus (HEV) infection is a significant cause of viral hepatitis and can lead to liver failure.
• Understanding the epidemiology and clinical course of HEV infections is crucial for patient management.

Purpose of the Study:

• To provide novel data on the epidemiology and clinical course of HEV infections.
• To analyze HEV infection data from Q1/2008 to Q3/2018 at the Vienna General Hospital.

Main Methods:

• Retrospective analysis of patient records for individuals tested for HEV.
• Identification of patients positive for HEV-IgM or HEV-PCR from a cohort of 88,945 tested individuals.
• Collated information on the course of infection, including severity, liver dysfunction, and outcomes.

Main Results:

• 151 patients were identified with HEV infection (median age 51 years, 45.8% female).
• 4.6% had non-severe, 7.3% severe without liver dysfunction, and 6.0% severe with liver dysfunction.
• Genotypes were predominantly GT-1 (71.4%) and GT-3 (28.6%). Hospitalization occurred in 60% of severe cases; ICU admission and 30-day mortality were low (1.9%).

Conclusions:

• Approximately half of patients with severe acute HEV infection required hospitalization.
• Admissions to the intensive care unit (ICU) and short-term mortality associated with HEV infection were low.
• Despite increased testing, diagnosed HEV infections remained constant at Vienna General Hospital between 2008-2018.