scholarly journals Th1/Th2 Cells and Associated Cytokines in Acute Hepatitis E and Related Acute Liver Failure

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Jian Wu ◽  
Yurong Guo ◽  
Xuan Lu ◽  
Fen Huang ◽  
Feifei Lv ◽  
...  
Keyword(s):  
Viral Load ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Acute Hepatitis ◽  
Hepatitis E ◽  
Th2 Cells ◽  
Upward Trend ◽  
Significant Difference ◽  
Acute Hepatitis E ◽  
Ifn Γ

Background and Aims. The involvement of cellular immunity in the development of hepatitis E virus (HEV) infection is rare. We aimed to study the roles of viral load and Th cell responses in acute hepatitis E (AHE) and HEV-related acute liver failure (HEV-ALF). Methods. We evaluated viral load and Th1/Th2 cytokine levels in 34 patients with HEV infection, including 17 each with AHE or HEV-ALF. Seventeen healthy controls (HCs) were also included who were negative for anti-HEV IgM and IgG. Results. There was no significant difference in viral load and HEV RNA in the AHE and HEV-ALF groups (both P > 0.05 ). The Th lymphocyte levels (CD3+, CD4+) in the AHE and HEV-ALF groups were significantly higher than those in the HC group (both P < 0.05 ), but there was no significant difference between the AHE and HEV-ALF groups ( P > 0.05 ). Both IFN-γ and IL-10 showed gradual upward trend from the HC group to the AHE (both P < 0.01 ), but IFN-γ showed a sharp downward trend from the AHE group to the HEV-ALF group ( P < 0.01 ) and IL-4 showed gradual upward trend from the AHE group to the HEV-ALF group ( P < 0.01 ).There was no significant difference in Th1 and Th2 cytokines between the HEV RNA(+) group and HEV RNA(-) group (all P > 0.05 ). Th2 bias was observed from the AHE ( ratio = 58.65 ) to HEV-ALF ( ratio = 1.20 ) groups. The level of IFN-γ was associated with the outcome of HEV-ALF patients. Conclusions. HEV viral load was not associated with aggravation of AHE, and the HEV-ALF patients showed significant Th2 bias, which may be involved in the aggravation of AHE.

scholarly journals Lethal biliary congestive acute hepatitis E without acute liver failure: A case report

Kanzo ◽  
2021 ◽  
Vol 62 (8) ◽  
pp. 463-470
Author(s):  
Nao Yamauchi ◽  
Tetsuya Yasunaka ◽  
Akinobu Takaki ◽  
Yoshimune Hinami ◽  
Masaru Kinomura ◽  
...  
Keyword(s):  
Case Report ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Acute Hepatitis ◽  
Hepatitis E ◽  
Acute Hepatitis E

scholarly journals Acute Hepatitis E: A Rare Cause of Acute Liver Failure in a Patient With Acute Myeloid Leukemia

Cureus ◽  
2020 ◽  
Author(s):  
Zachary Field ◽  
Michelle Russin ◽  
Rodrigo M Murillo Alvarez ◽  
Mario Madruga ◽  
Steve Carlan
Keyword(s):  
Acute Myeloid Leukemia ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Acute Hepatitis ◽  
Myeloid Leukemia ◽  
Hepatitis E ◽  
Acute Hepatitis E ◽  
Acute Myeloid

Does Hepatitis E Viral Load and Genotypes Influence the Final Outcome of Acute Liver Failure During Pregnancy?

2008 ◽  
Vol 103 (10) ◽  
pp. 2495-2501 ◽  
Author(s):  
Premashis Kar ◽  
Nishat Jilani ◽  
Syed A. Husain ◽  
Sayed Tazeen Pasha ◽  
Ranjana Anand ◽  
...  
Keyword(s):  
Viral Load ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Hepatitis E ◽  
Final Outcome

Does high viral load of hepatitis E virus influence the severity and prognosis of acute liver failure during pregnancy?

2012 ◽  
Vol 85 (4) ◽  
pp. 620-626 ◽  
Author(s):  
Jayanta Borkakoti ◽  
Rajib Kishore Hazam ◽  
Asim Mohammad ◽  
Ashok Kumar ◽  
Premashis Kar
Keyword(s):  
Viral Load ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Hepatitis E Virus ◽  
High Viral Load ◽  
Hepatitis E

Does High Viral Load of Hepatitis E Virus Influence the Severity and Prognosis of Acute Liver Failure During Pregnancy?

2013 ◽  
Vol 3 (1) ◽  
pp. S2
Author(s):  
Premashis Kar ◽  
Jayanta Borkakoti ◽  
Rajib Kishore Hazam ◽  
Mohammad Asim ◽  
Ashok Kumar
Keyword(s):  
Viral Load ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Hepatitis E Virus ◽  
High Viral Load ◽  
Hepatitis E

scholarly journals Bovine Serum Albumin Antibodies as a Disease Marker for Hepatitis E Virus Infection

2005 ◽  
Vol 2005 (4) ◽  
pp. 316-321 ◽  
Author(s):  
Medhat Haroun
Keyword(s):  
Bovine Serum Albumin ◽  
Serum Albumin ◽  
Acute Hepatitis ◽  
Bovine Serum ◽  
Hepatitis E ◽  
Serum Samples ◽  
Disease Marker ◽  
Normal Individuals ◽  
Significant Difference ◽  
Acute Hepatitis E

This report evaluates the significance of antibody/bovine serum albumin (BSA) interactions as a risk factor for the diagnosis of acute hepatitis E. Serum samples from 40 patients with acute hepatitis E and from 40 age/sex matched healthy adult subjects were tested for IgA, IgG, and IgM by ELISA and by turbidimetric assay. BSA was used as a target to characterize changes in levels of interacting immunoglobulins. Initial results obtained before removal of antibodies that interacted with BSA suggested that HEV patients had increased levels of IgM in their sera. It was found that normal individuals had mean IgA, IgG, and IgM levels of2.55mg/mL,9.80mg/mL, and1.73mg/mL, respectively while HEV patients had mean levels of2.66mg/mL,10.04mg/mL, and2.01mg/mL (P<.26,P<.32, andP<.0004). However, the mean level of IgM in HEV-infected sera after purification from antibodies that interacted with BSA was determined to be1.72mg/mL indicating that there was no significant difference in IgM level in HEV patients compared to normal individuals (P<.6). The presence of antibodies that interact with BSA might serve as a diagnostic tool for detection of high-risk patients.

scholarly journals Five-day outcome of hepatitis E-induced acute liver failure in the ICU

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Debashis Chowdhury ◽  
Farhana Mahmood ◽  
Cathryn Edwards ◽  
Simon D. Taylor-Robinson
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Poor Country ◽  
Hepatitis B Surface Antigen ◽  
Hepatitis E ◽  
Additional Risk Factor ◽  
List Type ◽  
Igm Antibody ◽  
Significant Difference ◽  
King’S College Criteria

Abstract Background Hepatitis E virus (HEV) is an important cause of acute liver failure (ALF) in Bangladesh with pregnant mothers being more vulnerable. As HEV occurs in epidemics, it limits medical capabilities in this resource-poor country. Cerebral oedema, resulting in raised intracranial pressure (ICP), is an important cause of morbidity and mortality. Practical treatments are currently few. To study the baseline characteristics and clinical outcome of HEV-induced ALF in a recent HEV epidemic To detect raised ICP clinically and observe response to mannitol infusion. This was a prospective cohort study from June until August 2018 of 20 patients admitted to the intensive care unit (ICU) of a major Bangladeshi Referral Hospital with HEV-induced ALF. We diagnosed HEV infection by detecting serum anti-HEV IgM antibody. All were negative for hepatitis B surface antigen and hepatitis A IgM antibody. Data were collected on 5-day outcome after admission to ICU, monitoring all patients for signs of raised ICP. An intravenous bolus of 20% mannitol was administered at a single time point to patients with raised ICP. Results Twenty patients were included in the study. Ten (50%) patients, seven (70%) females, received mannitol infusion. HE worsened in eight (40%): seven female and three pregnant. Glasgow Coma scores deteriorated in six (30%): all (100%) females and three pregnant. Consciousness status was not significantly different between pregnant and non-pregnant subjects, nor between those who received mannitol and those who did not. Six patients met King’s College Criteria for liver transplantation. Conclusions Female patients had a worse outcome, but pregnancy status was not an additional risk factor in our cohort. Mannitol infusion was also not associated with a significant difference in outcome.

scholarly journals Clinical Characteristics of Acute Hepatitis E and Their Correlation with HEV Genotype 3 Subtypes in Italy

Pathogens ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 832
Author(s):  
Claudia Minosse ◽  
Elisa Biliotti ◽  
Daniele Lapa ◽  
Alessia Rianda ◽  
Mauro Marchili ◽  
...  
Keyword(s):  
Viral Load ◽  
Acute Hepatitis ◽  
Epigastric Pain ◽  
Clinical Manifestations ◽  
Clinical Information ◽  
Hepatitis E ◽  
International Normalized Ratio ◽  
Genotype 3 ◽  
Lazio Region ◽  
Acute Hepatitis E

Genotype 3 (GT3) is responsible for most European autochthonous hepatitis E virus (HEV) infections. This study analyzed circulating genotypes and GT3 subtypes in the Lazio region, Italy, between 2011 and 2019, as well as their pathogenic characteristics. Of the 64 evaluable HEV GT3 patient-derived sequences, identified subtypes included GT3f (n = 36), GT3e (n = 15), GT3c (n = 9), GT3a (n = 1) and three unsubtyped GT3 sequences. GT3c strains were similar to Dutch sequences (96.8–98.1% identity), GT3e strains showed high similarity (96.8%) with a United Kingdom sequence, while the most related sequences to GT3f Italian strains were isolated in France, Belgium and Japan. One sequence was closely related to another Italian strain isolated in raw sewage in 2016. The liver functioning test median values for 56 evaluable GT3 patients were: alanine aminotransferase (ALT), 461 (range 52–4835 U/L); aspartate aminotransferase (AST), 659 (range 64–6588 U/L); and total bilirubin, 3.49 (range 0.4–33 mg/dL). The median HEV RNA viral load for 26 evaluable GT3 patients was 42,240 IU/mL (range 5680–895,490 IU/mL). Of the 37 GT3 patients with available clinical information, no correlation was observed between HEV clinical manifestations and GT3 subtype. HEV symptoms were comparable among GT3c/e/f patients across most analyzed categories except for epigastric pain, which occurred more frequently in patients with HEV GT3e (75%) than in patients with GT3c (50%) or GT3f (19%) (p = 0.01). Additionally, patients with HEV GT3c exhibited significantly higher median international normalized ratio (INR) than patients with GT3e and GT3f (p = 0.033). The severity of GT3 acute hepatitis E was not linked to HEV RNA viral load or to the GT3 subtype.

scholarly journals Association of poor virus specific immunoglobulin G antibody responses with higher viral load is seen in Bangladeshi pregnant women having acute Hepatitis E Genotype 1 infection

2020 ◽  
Author(s):  
Rosy Sultana ◽  
Md Tarikul Islam ◽  
Golam Sarower Bhuyan ◽  
Farjana Akther Noor ◽  
Suprovath Kumar Sarker ◽  
...  
Keyword(s):  
Viral Load ◽  
Acute Hepatitis ◽  
Pregnant Women ◽  
South Asian ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Genotype 1 ◽  
Asian Countries ◽  
Igg Antibody ◽  
Acute Hepatitis E

AbstractAlthough Hepatitis E viral illness is usually self-limiting, higher rates of morbidity and mortality are frequently observed during pregnancy in South Asian countries including Bangladesh. Of the four common variants, hepatitis E virus genotype 1 is mainly prevalent in South Asian countries. Pregnant women usually suffer from a state of immunosuppression. It is yet to be known whether virus specific immunoglobulin G (IgG) immune responses have any association with the vulnerability of pregnant women to acute hepatitis with E virus. The study aimed to compare the viral load and IgG responses of hepatitis E-infected pregnant women with that of non-pregnant women with same infection. Real Time –quantitative reverse transcription Polymerase Chain Reaction and Sanger sequencing were performed to determine the viral load and genotype, respectively, whereas Enzyme Linked Immunosorbent Assay method was used to determine hepatitis E virus specific serum IgG antibody index along with IgG avidity index. Although significant negative correlations were observed between log viral copy number and log IgG antibody index in the late acute phases of jaundice for both pregnant (r= −0.7971, p=0.0002) and non-pregnant women (r= −0.9117, p=0.0002), serum log viral copy number of pregnant women was significantly higher than that of the non-pregnant counterpart (p=0.0196) in the late acute stage of jaundice. In addition, log hepatitis E virus IgG antibody index of pregnant women was significantly lower than the non-pregnant women in the late phase of jaundice induced by hepatitis E virus (p=0.0303). Moreover, pregnant women with acute hepatitis E had higher cross-reactive IgG than in the non-pregnant women (p=0.0017). All the patients got infected with hepatitis E virus were in Genotype 1 variety. The study demonstrates that virus-specific poor IgG responses might be responsible for vulnerability of pregnant women to acute hepatitis with hepatitis E virus.Author SummaryAcute hepatitis caused by hepatitis E virus (HEV) Genotype 1 is a public health problem in Asian countries and especially it poses a potential health threat to pregnant women causing 19% to 25% mortality, particularly in South Asian countries including Bangladesh. The study aimed to explore whether HEV IgG immune responses were compromised during pregnancy, which might contribute to higher viral load and disease severity. Accordingly, pregnant and non-pregnant women with acute hepatitis (clinically presented with nausea, loss of appetite and /or jaundice) were enrolled from different tertiary care hospitals in Dhaka city. All these patients were screened and hepatitis E were differentiated from other hepatitis (caused by A, B, C) using Enzyme Linked Immunosorbent Assay (ELISA) methods. HEV IgG antibody/avidity indices and viral loads were measured using ELISA and real time quantitative polymerase chain reaction (RT-qPCR), respectively. The study showed that pregnant women with acute hepatitis E had lower IgG indices with higher viral load than their non-pregnant counterpart. Overall, the study revealed that virus-specific poor IgG responses might render pregnant women vulnerable to acute hepatitis E of varying degree of severity which might be associated with higher viral load.

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