TITLE:
Hepatitis E is more common than hepatitis A among returning travellers presenting to tertiary care
AUTHORS:
Catherine Cosgrove, Margaret Armstrong, Mike Kidd, Michael Brown, Tom Doherty
KEYWORDS:
Hepatitis; Returning Traveller
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.3 No.8,
November
28,
2013
ABSTRACT: Introduction: Acute viral hepatitis
is a relatively common infection resulting in hospital attendance after foreign
travel. Travellers and doctors are generally aware of hepatitis A and the fact
that safe and effective immunisation is available. In contrast, there is no widely
available vaccine for hepatitis E and most physicians’ experience with this
condition is limited. Over the last few
years, the number of cases of hepatitis E has increased. Methods: We
examined the prevalence of hepatitis A and E among patients presenting to the
Hospital for Tropical Diseases between 2000 and 2009. Travel history,
demographics and laboratory parameters of these patients were compared. Results:
The annual incidence of hepatitis A remained static, while that of hepatitis E
increased from 1 to 4. Hepatitis E was associated with older age, travel to the
Indian sub-continent (ISC), and visiting friends and relatives (VFR). Peak ALT
was similar between patients with hepatitis A or E, but as many as a third of
those with hepatitis E developed a prolonged INR, compared to 11% of those with
hepatitis A. In addition, patients with hepatitis E had a longer hospital
admission by a median of 3 days. Conclusion: Hepatitis E is now the commonest
cause of faeco-oral viral hepatitis at this centre, and is associated with
laboratory features suggestive of more severe liver damage and longer hospital
stay.