Department of Clinical Pathology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Liver Int. 2011 Aug;31(7):1001-5. doi: 10.1111/j.1478-3231.2011.02521.x. Epub 2011 Mar 30.
The vast majority of patients who are referred to a specialist hepatological centre suffer from acute deterioration of their chronic liver disease. Yet, this entity of acute on chronic liver failure remains poorly defined.
The aim of the present study was to highlight the occurrence of hepatitis E viraemia by nested reverse transcriptase polymerase chain reaction (RT-PCR) in patients with acute on chronic liver failure.
The study included 100 patients with acute on chronic liver disorders admitted to Mansoura University Hospital, Egypt. Blood samples were obtained from patients and sera were separated. Sera were subjected to a study of viral hepatitis markers for hepatitis A by IgM, for hepatitis B by S antigen and core IgM and for hepatitis C virus by IgG and RT-PCR for HCV. Liver function tests were evaluated including alanine transaminase, aspartate transaminase and bilirubin total and direct by an autoanalyser. Study for hepatitis E virus (HEV) was performed using a molecular technique. Nested RT-PCR was performed for each serum sample.
HEV RNA was detected in the sera of 13 patients (13%) of the patients with chronic liver disorders. The majority of the positive cases were among patients with cirrhosis (29.9%) followed by patients with HCC (15.4%). On multirisk analysis for the factors associated with the presence of HEV viraemia, younger age < 45 years and lower albumin level < 3.5 g/dl were significantly (P = 0.04, P = 0.03) associated with HEV viraemia.
From this study it appears that HEV viraemia is a common cause of acute on chronic liver disorders in Egypt.
There is no effective vaccine is available against HEV, mass awareness and preventive measures are important to the related.
绝大多数被转介到专科肝中心的患者患有慢性肝病的急性恶化。然而，这种慢性肝衰竭的急性发作的实体仍然定义不明确。
本研究旨在通过巢式逆转录聚合酶链反应（RT-PCR）突出急性肝衰竭患者中戊型肝炎病毒血症的发生。
本研究包括 100 名患有急性慢性肝紊乱的患者，他们入住埃及曼苏拉大学医院。从患者中采集血液样本，并分离血清。对血清进行甲型肝炎 IgM 标志物、乙型肝炎 S 抗原和核心 IgM 标志物以及丙型肝炎病毒 IgG 和 RT-PCR 检测。使用自动分析仪评估肝功能试验，包括丙氨酸转氨酶、天冬氨酸转氨酶和总胆红素及直接胆红素。使用分子技术进行戊型肝炎病毒（HEV）研究。对每个血清样本进行巢式 RT-PCR。
在 13%的慢性肝病患者的血清中检测到 HEV RNA。大多数阳性病例发生在肝硬化患者（29.9%）中，其次是 HCC 患者（15.4%）。多风险分析显示，年龄<45 岁和白蛋白水平<3.5 g/dl 与 HEV 病毒血症的存在显著相关（P=0.04，P=0.03）。
从这项研究中可以看出，HEV 病毒血症是埃及急性慢性肝紊乱的常见原因。
目前尚无针对 HEV 的有效疫苗，大规模的宣传和预防措施对相关疾病很重要。
