Hepatitis E natural history: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
Line 10: Line 10:


===Acute Hepatitis E===
===Acute Hepatitis E===
The clinical course of acute hepatitis E progresses according to the following phases:<ref name="pmid22549046">{{cite journal| author=Kamar N, Bendall R, Legrand-Abravanel F, Xia NS, Ijaz S, Izopet J et al.| title=Hepatitis E. | journal=Lancet | year= 2012 | volume= 379 | issue= 9835 | pages= 2477-88 | pmid=22549046 | doi=10.1016/S0140-6736(11)61849-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22549046  }} </ref><ref name="pmid18617784">{{cite journal| author=Dalton HR, Stableforth W, Thurairajah P, Hazeldine S, Remnarace R, Usama W et al.| title=Autochthonous hepatitis E in Southwest England: natural history, complications and seasonal variation, and hepatitis E virus IgG seroprevalence in blood donors, the elderly and patients with chronic liver disease. | journal=Eur J Gastroenterol Hepatol | year= 2008 | volume= 20 | issue= 8 | pages= 784-90 | pmid=18617784 | doi=10.1097/MEG.0b013e3282f5195a | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18617784  }} </ref><ref name="pmid18462508">{{cite journal| author=Borgen K, Herremans T, Duizer E, Vennema H, Rutjes S, Bosman A et al.| title=Non-travel related Hepatitis E virus genotype 3 infections in the Netherlands; a case series 2004 - 2006. | journal=BMC Infect Dis | year= 2008 | volume= 8 | issue=  | pages= 61 | pmid=18462508 | doi=10.1186/1471-2334-8-61 | pmc=PMC2413240 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18462508  }} </ref><ref name="pmid21453549">{{cite journal| author=Zhang S, Wang J, Yuan Q, Ge S, Zhang J, Xia N et al.| title=Clinical characteristics and risk factors of sporadic Hepatitis E in central China. | journal=Virol J | year= 2011 | volume= 8 | issue=  | pages= 152 | pmid=21453549 | doi=10.1186/1743-422X-8-152 | pmc=PMC3082222 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21453549  }} </ref>
In [[endemic]] areas, hepatitis E commonly presents as acute icteric hepatitis, similarly to other types of [[viral hepatitis]].  The clinical course of acute hepatitis E progresses according to the following phases:<ref name="pmid22549046">{{cite journal| author=Kamar N, Bendall R, Legrand-Abravanel F, Xia NS, Ijaz S, Izopet J et al.| title=Hepatitis E. | journal=Lancet | year= 2012 | volume= 379 | issue= 9835 | pages= 2477-88 | pmid=22549046 | doi=10.1016/S0140-6736(11)61849-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22549046  }} </ref><ref name="pmid18617784">{{cite journal| author=Dalton HR, Stableforth W, Thurairajah P, Hazeldine S, Remnarace R, Usama W et al.| title=Autochthonous hepatitis E in Southwest England: natural history, complications and seasonal variation, and hepatitis E virus IgG seroprevalence in blood donors, the elderly and patients with chronic liver disease. | journal=Eur J Gastroenterol Hepatol | year= 2008 | volume= 20 | issue= 8 | pages= 784-90 | pmid=18617784 | doi=10.1097/MEG.0b013e3282f5195a | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18617784  }} </ref><ref name="pmid18462508">{{cite journal| author=Borgen K, Herremans T, Duizer E, Vennema H, Rutjes S, Bosman A et al.| title=Non-travel related Hepatitis E virus genotype 3 infections in the Netherlands; a case series 2004 - 2006. | journal=BMC Infect Dis | year= 2008 | volume= 8 | issue=  | pages= 61 | pmid=18462508 | doi=10.1186/1471-2334-8-61 | pmc=PMC2413240 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18462508  }} </ref><ref name="pmid21453549">{{cite journal| author=Zhang S, Wang J, Yuan Q, Ge S, Zhang J, Xia N et al.| title=Clinical characteristics and risk factors of sporadic Hepatitis E in central China. | journal=Virol J | year= 2011 | volume= 8 | issue=  | pages= 152 | pmid=21453549 | doi=10.1186/1743-422X-8-152 | pmc=PMC3082222 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21453549  }} </ref>
*'''Incubation period'''
*'''Incubation period'''
:*Lasts 3 to 8 weeks, with a mean of 40 days
:*Lasts 3 to 8 weeks, with a mean of 40 days
*'''Prodromal phase'''
*'''Prodromal or Preicteric Phase'''
*'''Symptomatic period'''
:*Lasts for a few days
:*Lasts days to weeks
:*Initial symptoms are unspecific and may include:
:*Initial [[symptoms]] are unspecific and may include:
 
::*[[Fever]]
::*[[Weakness]]
::*[[Myalgia]]
::*[[Myalgia]]
::*[[Arthralgia]]
::*[[Arthralgia]]
::*[[Weakness]]
::*[[Anorexia]]
::*[[Dysgeusia]]
::*[[Nausea]]
::*[[Nausea]]
::*[[Vomiting]]
::*[[Vomiting]]
::*[[Abdominal pain]]
::*[[Diarrhea]]
*'''Symptomatic period'''
:*More specific [[symptoms]] may include:
:*More specific [[symptoms]] may include:
::*[[Jaundice]]
::*[[Jaundice]]

Revision as of 14:57, 26 August 2014

Hepatitis E Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Screening

Differentiating Hepatitis E from other Diseases

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Treatment

Medical Therapy

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Hepatitis E natural history On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hepatitis E natural history

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hepatitis E natural history

CDC on Hepatitis E natural history

Hepatitis E natural history in the news

Blogs on Hepatitis E natural history

Directions to Hospitals Treating Hepatitis E

Risk calculators and risk factors for Hepatitis E natural history

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

Natural History

Children with hepatitis E are often asymptomatic.[1] Hepatitis E may be classified in acute and chronic disease.[2]

Acute Hepatitis E

In endemic areas, hepatitis E commonly presents as acute icteric hepatitis, similarly to other types of viral hepatitis. The clinical course of acute hepatitis E progresses according to the following phases:[3][4][5][6]

  • Incubation period
  • Lasts 3 to 8 weeks, with a mean of 40 days
  • Prodromal or Preicteric Phase
  • Lasts for a few days
  • Initial symptoms are unspecific and may include:
  • Symptomatic period

Pregnant women, and patients with end-stage liver disease may experience more severe cases of hepatitis, possibly progressing into hepatic failure. The more complicated course of the disease in pregnant women is thought to be due to the characteristic immunity and hormonal changes that occur during pregnancy.[7][8] Additionally, fatal outcomes of hepatitis E in pregnant women were associated with the decrease of progesterone receptors.[9]

Chronic Hepatitis E

Complications

Extra-Hepatic

Hepatitis E may also present with extra-hepatic manifestations, including:[2][10][11]

Prognosis

Hepatitis E is self-limited in most immunocompetent patients. In these cases the prognosis is often good. Immunocompromised patients, and those with end-stage liver disease are at higher risk of developing chronic hepatitis and other complications. This last group of patients have a poor prognosis.[3]

References

  1. ↑ Buti M, Plans P, Domínguez A, Jardi R, Rodriguez Frias F, Esteban R; et al. (2008). "Prevalence of hepatitis E virus infection in children in the northeast of Spain". Clin Vaccine Immunol. 15 (4): 732–4. doi:10.1128/CVI.00014-08. PMC 2292657. PMID 18321881.
  2. ↑ 2.0 2.1 Hoofnagle JH, Nelson KE, Purcell RH (2012). "Hepatitis E." N Engl J Med. 367 (13): 1237–44. doi:10.1056/NEJMra1204512. PMID 23013075.
  3. ↑ 3.0 3.1 Kamar N, Bendall R, Legrand-Abravanel F, Xia NS, Ijaz S, Izopet J; et al. (2012). "Hepatitis E." Lancet. 379 (9835): 2477–88. doi:10.1016/S0140-6736(11)61849-7. PMID 22549046.
  4. ↑ Dalton HR, Stableforth W, Thurairajah P, Hazeldine S, Remnarace R, Usama W; et al. (2008). "Autochthonous hepatitis E in Southwest England: natural history, complications and seasonal variation, and hepatitis E virus IgG seroprevalence in blood donors, the elderly and patients with chronic liver disease". Eur J Gastroenterol Hepatol. 20 (8): 784–90. doi:10.1097/MEG.0b013e3282f5195a. PMID 18617784.
  5. ↑ Borgen K, Herremans T, Duizer E, Vennema H, Rutjes S, Bosman A; et al. (2008). "Non-travel related Hepatitis E virus genotype 3 infections in the Netherlands; a case series 2004 - 2006". BMC Infect Dis. 8: 61. doi:10.1186/1471-2334-8-61. PMC 2413240. PMID 18462508.
  6. ↑ Zhang S, Wang J, Yuan Q, Ge S, Zhang J, Xia N; et al. (2011). "Clinical characteristics and risk factors of sporadic Hepatitis E in central China". Virol J. 8: 152. doi:10.1186/1743-422X-8-152. PMC 3082222. PMID 21453549.
  7. ↑ Wedemeyer H, Pischke S, Manns MP (2012). "Pathogenesis and treatment of hepatitis e virus infection". Gastroenterology. 142 (6): 1388–1397.e1. doi:10.1053/j.gastro.2012.02.014. PMID 22537448.
  8. ↑ Navaneethan U, Al Mohajer M, Shata MT (2008). "Hepatitis E and pregnancy: understanding the pathogenesis". Liver Int. 28 (9): 1190–9. doi:10.1111/j.1478-3231.2008.01840.x. PMC 2575020. PMID 18662274.
  9. ↑ Bose PD, Das BC, Kumar A, Gondal R, Kumar D, Kar P (2011). "High viral load and deregulation of the progesterone receptor signaling pathway: association with hepatitis E-related poor pregnancy outcome". J Hepatol. 54 (6): 1107–13. doi:10.1016/j.jhep.2010.08.037. PMID 21145845.
  10. ↑ Kamar N, Weclawiak H, Guilbeau-Frugier C, Legrand-Abravanel F, Cointault O, Ribes D; et al. (2012). "Hepatitis E virus and the kidney in solid-organ transplant patients". Transplantation. 93 (6): 617–23. doi:10.1097/TP.0b013e318245f14c. PMID 22298032.
  11. ↑ Kamar N, Izopet J, Cintas P, Garrouste C, Uro-Coste E, Cointault O; et al. (2010). "Hepatitis E virus-induced neurological symptoms in a kidney-transplant patient with chronic hepatitis". Am J Transplant. 10 (5): 1321–4. doi:10.1111/j.1600-6143.2010.03068.x. PMID 20346067.

Template:WS Template:WH

Retrieved from "https://www.wikidoc.org/index.php?title=Hepatitis_E_natural_history&oldid=1013245"