Abstract | BACKGROUND & AIMS: METHODS: RESULTS: Among 318 patients with suspected drug-induced liver injury, 50 (16%) tested positive for anti-HEV IgG and 9 (3%) for anti-HEV IgM. The samples that contained anti-HEV IgM (collected 2 to 24 weeks after onset of symptoms) included 4 that tested positive for HEV RNA genotype 3. Samples from the 6-month follow-up visit were available from 4 patients; they were negative for anti-HEV IgM, but levels of anti-HEV IgG increased with time. Patients who had anti-HEV IgM were mostly older men (89%; mean age, 67 years), and 2 were human immunodeficiency virus positive. Clinical reassessment of the 9 patients with anti-HEV IgM indicated that acute hepatitis E was the most likely diagnosis for 7 and might be the primary diagnosis for 2. CONCLUSIONS: HEV infection contributes to a small but important proportion of cases of acute liver injury that are suspected to be drug induced. Serologic testing for HEV infection should be performed, particularly if clinical features are compatible with acute viral hepatitis.
|
Authors | Timothy J Davern, Naga Chalasani, Robert J Fontana, Paul H Hayashi, Petr Protiva, David E Kleiner, Ronald E Engle, Hanh Nguyen, Suzanne U Emerson, Robert H Purcell, Hans L Tillmann, Jiezhun Gu, Jose Serrano, Jay H Hoofnagle, Drug-Induced Liver Injury Network (DILIN) |
Journal | Gastroenterology
(Gastroenterology)
Vol. 141
Issue 5
Pg. 1665-72.e1-9
(Nov 2011)
ISSN: 1528-0012 [Electronic] United States |
PMID | 21855518
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, N.I.H., Intramural)
|
Copyright | Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Hepatitis Antibodies
- Immunoglobulin G
- Immunoglobulin M
|
Topics |
- Acute Disease
- Acute Lung Injury
(blood, epidemiology, etiology)
- Adult
- Aged
- Aged, 80 and over
- Chemical and Drug Induced Liver Injury
(blood, diagnosis, epidemiology)
- Diagnosis, Differential
- Female
- Hepatitis Antibodies
(blood)
- Hepatitis E
(complications, diagnosis, epidemiology)
- Hepatitis E virus
(immunology)
- Humans
- Immunoglobulin G
(blood)
- Immunoglobulin M
(blood)
- Male
- Middle Aged
- Prevalence
- Prospective Studies
- Retrospective Studies
- United States
(epidemiology)
|