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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>
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 phase'''
*'''Symptomatic period'''
*'''Symptomatic period'''
**Lasts days to weeks
:*Lasts days to weeks
**Initial symptoms are unspecific and may include:
:*Initial symptoms are unspecific and may include:
***[[Myalgia]]
::*[[Myalgia]]
 
::*[[Arthralgia]]
***[[Arthralgia]]
::*[[Weakness]]
 
::*[[Nausea]]
***[[Weakness]]
::*[[Vomiting]]
 
:*More specific symptoms may include:
***[[Nausea]]
::*[[Jaundice]]
 
::*[[Itching]]
***[[Vomiting]]
::*[[Acholic stools]]
 
::*[[Dark-colored urine]]
**More specific symptoms may include:
***[[Jaundice]]
 
***[[Itching]]
 
***[[Acholic stool]]
 
***[[Dark-colored urine]]




Revision as of 21:29, 25 August 2014

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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

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 phase
  • Symptomatic period
  • Lasts days to weeks
  • Initial symptoms are unspecific and may include:
  • More specific symptoms may include:


Chronic Hepatitis E

Complications

  • "Acute-on-chronic disease"

Extra-Hepatic

Prognosis

In most immunocompetent patients, hepatitis E is self-limited. 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. ↑ 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.

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