FREQUENCY OF CHOLESTASIS AMONG THE PATIENTS SUFFERING FROM HEPATITIS E VIRUS
Main Article Content
Keywords
Hepatitis E, Cholestasis, Liver Function, Jaundice, Pakistan.
Abstract
Background: Hepatitis E virus (HEV) continues to be the leading aetiology of acute viral hepatitis in Pakistan, where cholestasis is a common but mostly unrecognised complication, which, among other things, can extend the duration of the disease and impede the recovery.
Objective: To determine the frequency of cholestasis in patients with Hepatitis E virus infection.
Materials and Methods: This descriptive cross-sectional study took place in the Department of Gastroenterology, PGMI/Shaikh Zayed Hospital, Lahore, from 18 March to 18 September 2021. 189 HEV-positive patients who underwent clinical examination and liver function tests for the detection of cholestasis were included in the study.
Results: Cholestasis developed in 90 (47.6%) of 189 patients. The majority of patients were of middle age, and males were more commonly affected. High bilirubin and ALP levels were the principal markers of cholestasis.
Conclusion: Cholestasis is frequently a complication of HEV infection. Therefore, timely identification and observation play an important role in improving prognosis.
References
2. Gorris M, van Der Lecq BM, van Erpecum KJ, de Bruijne J. Treatment for chronic hepatitis E virus infection: a systematic review and meta‐analysis. Journal of Viral Hepatitis. 2021 Mar;28(3):454-63.
3. Zhao H, Ye W, Yu X, Hu J, Zhang X, Yang M, Sheng J, Shi Y. Hepatitis E virus superinfection impairs long-term outcome in hospitalized patients with hepatitis B virus-related decompensated liver cirrhosis. Annals of Hepatology. 2023 Mar 1;28(2):100878.
4. Horvatits T, Wißmann JE, Johne R, Groschup MH, Gadicherla AK, Zur Wiesch JS, Eiden M, Todt D, Reimer R, Dähnert L, Schöbel A. Hepatitis E virus persists in the ejaculate of chronically infected men. Journal of Hepatology. 2021 Jul 1;75(1):55-63.
5. Wu J, Xiang Z, Zhu C, Yao Y, Bortolanza M, Cao H, Li L. Extrahepatic manifestations related to hepatitis E virus infection and their triggering mechanisms. Journal of Infection. 2021 Sep 1;83(3):298-305.
6. Kupke P, Werner JM. Hepatitis E virus infection—immune responses to an underestimated global threat. Cells. 2021 Sep 2;10(9):2281.
7. Abravanel F, Nicot F, Lhomme S, Cazabat M, Drumel T, Velay A, Latour J, Belliere J, Cintas P, Kamar N, Izopet J. Hepatitis E virus quasispecies in cerebrospinal fluid with neurological manifestations. Vaccines. 2021 Oct 19;9(10):1205.
8. Klöhn M, Schrader JA, Brüggemann Y, Todt D, Steinmann E. Beyond the usual suspects: Hepatitis E virus and its implications in hepatocellular carcinoma. Cancers. 2021 Nov 22;13(22):5867.
9. Pellerin M, Hirchaud E, Blanchard Y, Pavio N, Doceul V. Characterization of a cell culture system of persistent hepatitis E virus infection in the human HepaRG hepatic cell line. Viruses. 2021 Mar 4;13(3):406.
10. Dudman S, Zerja A, Hasanoğlu İ, Ruta S, van Welzen B, Nicolini LA, Yonga P, Øverbø J, Rawat S, Habibovic S, Kim TB. Global vaccination against hepatitis E virus: position paper from the European Society of Clinical Microbiology and Infectious Diseases Viral Hepatitis Study Group. Clinical Microbiology and Infection. 2025 Feb 1;31(2):201-10.
11. Parraud D, Lhomme S, Péron JM, Da Silva I, Tavitian S, Kamar N, Izopet J, Abravanel F. Rat hepatitis E virus: presence in humans in South-Western France?. Frontiers in Medicine. 2021 Sep 3;8:726363.
12. Affeldt P, Di Cristanziano V, Grundmann F, Wirtz M, Kaiser R, Benzing T, Stippel D, Kann M, Kurschat C. Monitoring of hepatitis E virus RNA during treatment for chronic hepatitis E virus infection after renal transplantation. Immunity, Inflammation and Disease. 2021 Jun;9(2):513-20.
13. Fantilli A, López Villa SD, Zerega A, Di Cola G, López L, Wassaf Martínez M, Pisano MB, Ré VE. Hepatitis E virus infection in a patient with alcohol-related chronic liver disease: a case report of acute-on-chronic liver failure. Virology Journal. 2021 Dec 9;18(1):245.
14. Glitscher M, Himmelsbach K, Woytinek K, Schollmeier A, Johne R, Praefcke GJ, Hildt E. Identification of the interferon-inducible GTPase GBP1 as a major restriction factor for hepatitis E virus. Journal of Virology. 2021 Mar 10;95(7):10-128.
15. Lin S, Zhang YJ. Advances in hepatitis E virus biology and pathogenesis. Viruses. 2021 Feb 9;13(2):267.
16. Rivero-Juarez A, Frias M, Perez AB, Pineda JA, Reina G, Fuentes-Lopez A, Freyre-Carrillo C, Ramirez-Arellano E, Alados JC, Rivero A. Orthohepevirus C infection as an emerging cause of acute hepatitis in Spain: First report in Europe. Journal of Hepatology. 2022 Aug 1;77(2):326-31.
17. Kemming J, Gundlach S, Panning M, Huzly D, Huang J, Lütgehetmann M, Pischke S, Zur Wiesch JS, Emmerich F, Llewellyn-Lacey S, Price DA. Mechanisms of CD8+ T-cell failure in chronic hepatitis E virus infection. Journal of Hepatology. 2022 Oct 1;77(4):978-90.

