Hepatitis E virus in patients with acute severe liver injury

doi:10.4254/wjh.v6.i6.426

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World Journal of Hepatology

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1948-5182

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Hepatol. Jun 27, 2014; 6(6): 426-434
Published online Jun 27, 2014. doi: 10.4254/wjh.v6.i6.426

Hepatitis E virus in patients with acute severe liver injury

Claire Louise Crossan, Kenneth J Simpson, Darren G Craig, Christopher Bellamy, Janice Davidson, Harry R Dalton, Linda Scobie

Claire Louise Crossan, Department of Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, United Kingdom

Kenneth J Simpson, Darren G Craig, Janice Davidson, Scottish Liver Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, United Kingdom

Christopher Bellamy, Department of Pathology, University of Edinburgh, Edinburgh, EH16 4SB, United Kingdom

Harry R Dalton, Gastrointestinal Unit, Royal Cornwall Hospital, and European Centre for the Environment and Human Health, University of Exeter Medical School, Truro, TR1 3HD, United Kingdom

Linda Scobie, Department of Life Sciences, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, United Kingdom

Author contributions: Crossan CL carried out the molecular and serological assays and drafted the manuscript; Simpson KJ, Dalton HR and Scobie L conceived the study and participated in its design and co-ordination, statistical analysis, funding and final reviewing of the manuscript; Craig DG and Davidson J participated in the collection and processing of the samples from the patients; Bellamy C carried out all histopathology; all authors read and approved the final manuscript.

Supported by Chief Scientist Office Scotland (under project ETM/32)

Correspondence to: Linda Scobie, PhD, Department of Life Sciences, School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, United Kingdom. linda.scobie@gcu.ac.uk

Telephone: +44-141-3318534 Fax: +44-141-3313208

Received: December 18, 2013
Revised: April 8, 2014
Accepted: May 29, 2014
Published online: June 27, 2014
Processing time: 176 Days and 23.6 Hours

Core Tip

Core tip: Misdiagnosis of hepatitis E infection in drug induced liver injury has been noted in patients previously in South East England (13%) and the United States (3%). However, hepatitis E virus is still not given precedence when diagnosing these individuals. In our study, 5% of individuals tested were misdiagnosed and viraemic. It is an important clinical point that the diagnosis of drug induced liver injury is not secure without first excluding hepatitis E, irrespective of travel history, particularly in patients with elevated transaminases.