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Hepatitis E infection is an infrequent cause of acute hepatitis in the metropolitan area of Buenos Aires.
Journal of Clinical Virology ( IF 4.0 ) Pub Date : 2020-03-06 , DOI: 10.1016/j.jcv.2020.104309
Manuel Mendizabal 1 , Leila Haddad 2 , Sebastián Marciano 3 , Federico Orozco Ganem 4 , Silvina Paz 5 , Fernando Gruz 6 , Ezequiel Ridruejo 7 , María Fernanda Lurbet 8 , Nora Fernandez 9 , Valeria Descalzi 10 , Margarita Anders 11 , Adrián Gadano 3 , Alfredo Martínez 12 , Y Marcelo Silva 1
Affiliation  

Background Argentina is considered a region of low seroprevalence of hepatitis E virus (HEV), however; no studies have evaluated its burden among acute hepatitis cases. OBJECTIVES We aimed to estimate the proportion of acute HEV and outcome in a cohort of patients with acute hepatitis from 6 liver units in the Metropolitan area of Buenos Aires (MABA). STUDY DESIGN We performed a prospective cohort study including patients ≥18 years with acute hepatitis (increase in transaminases x 5 ULN) fromJuly 2016 to May 2018. Severe hepatitis was defined as acute hepatitis + INR> 1.5 and acute liver failure as severe hepatitis + encephalopathy. In patients in whom other etiologies were excluded, HEV tests were performed: anti-HEV IgM/G and HEV-RNA in serum and feces. RESULTS Overall, 268 patients with acute hepatitis were included in the study. The most frequent etiologies of acute hepatitis were hepatitis B (67patients, 25 %), hepatotoxicity (65, 24 %) and autoimmune hepatitis (26, 10 %). Acute HEV infection was confirmed in 8 (2.98 %; 95 %CI 1.25-5.63) patients who tested positive for anti-HEV IgM. A total of 63 (23.5 %) patients were hospitalized and 9 (3.3 %) patients died. Overall, 48 (18 %) patients developed severe hepatitis, 6 (2.2 %) have acute liver failure, 6 (1.9 %) underwent liver transplantation and 9 (3.4 %) patients died. CONCLUSIONS the proportion of acute HEV in MABA was low during the period studied. We believe our findings will aid physicians prioritize other etiologies of acute hepatitis over HEV in order to optimize diagnostic resources and offer better care to their patients.

中文翻译:

戊型肝炎感染是布宜诺斯艾利斯大都市地区急性肝炎的罕见原因。

背景技术然而,阿根廷被认为是戊型肝炎病毒(HEV)血清阳性率较低的地区。没有研究评估其在急性肝炎病例中的负担。目的我们旨在估计布宜诺斯艾利斯大都会地区(MABA)六个肝脏单位的一组急性肝炎患者的急性HEV比例和结果。研究设计我们进行了一项前瞻性队列研究,从2016年7月至2018年5月包括≥18岁的急性肝炎(转氨酶升高x 5 ULN)。严重肝炎定义为急性肝炎+ INR> 1.5,急性肝衰竭定义为重度肝炎+脑病。 。在排除其他病因的患者中,进行了HEV检测:血清和粪便中的抗HEV IgM / G和HEV-RNA。结果总体上,该研究包括268例急性肝炎患者。急性肝炎最常见的病因是乙型肝炎(67例患者,占25%),肝毒性(65%,24%)和自身免疫性肝炎(26%,占10%)。确认有8例(2.98%; 95%CI 1.25-5.63)的抗HEV IgM阳性的患者发生了急性HEV感染。总共63例(23.5%)住院,9例(3.3%)死亡。总体而言,有48(18%)名患者患有严重的肝炎,有6(2.2%)名患有急性肝衰竭,有6名(1.9%)接受了肝移植,有9名(3.4%)死亡。结论在研究期间,急性HEV在MABA中的比例较低。我们相信我们的发现将有助于医生将急性肝炎的其他病因优先于HEV,以优化诊断资源并为患者提供更好的护理。肝毒性(65,24%)和自身免疫性肝炎(26,10%)。确认有8例(2.98%; 95%CI 1.25-5.63)的抗HEV IgM阳性的患者发生了急性HEV感染。总共63例(23.5%)住院,9例(3.3%)死亡。总体而言,有48(18%)名患者患有严重的肝炎,有6(2.2%)名患有急性肝衰竭,有6名(1.9%)接受了肝移植,有9名(3.4%)死亡。结论在研究期间,急性HEV在MABA中的比例较低。我们相信我们的发现将有助于医生将急性肝炎的其他病因优先于HEV,以优化诊断资源并为患者提供更好的护理。肝毒性(65,24%)和自身免疫性肝炎(26,10%)。确认有8例(2.98%; 95%CI 1.25-5.63)的抗HEV IgM阳性的患者发生了急性HEV感染。总共63例(23.5%)住院,9例(3.3%)死亡。总体而言,有48(18%)名患者患有严重的肝炎,有6(2.2%)名患有急性肝衰竭,有6名(1.9%)接受了肝移植,有9名(3.4%)死亡。结论在研究期间,急性HEV在MABA中的比例较低。我们相信我们的发现将有助于医生将急性肝炎的其他病因优先于HEV,以优化诊断资源并为患者提供更好的护理。总共63例(23.5%)住院,9例(3.3%)死亡。总体而言,有48(18%)名患者患有严重的肝炎,有6(2.2%)名患有急性肝衰竭,有6名(1.9%)接受了肝移植,有9名(3.4%)死亡。结论在研究期间,急性HEV在MABA中的比例较低。我们相信我们的发现将有助于医生将急性肝炎的其他病因优先于HEV,以优化诊断资源并为患者提供更好的护理。总共63例(23.5%)住院,9例(3.3%)死亡。总体而言,有48(18%)名患者患有严重的肝炎,有6(2.2%)名患有急性肝衰竭,有6名(1.9%)接受了肝移植,有9名(3.4%)死亡。结论在研究期间,急性HEV在MABA中的比例较低。我们相信我们的发现将有助于医生将急性肝炎的其他病因优先于HEV,以优化诊断资源并为患者提供更好的护理。
更新日期:2020-03-06
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