Acute Hepatitis E Complicated With Liver Fibrosis:Report of One Case

Xinyue LIU, Huiying RAO, Rui HUANG

Acta Academiae Medicinae Sinicae ›› 2025, Vol. 47 ›› Issue (4) : 666-672.

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Acta Academiae Medicinae Sinicae

Abbreviation (ISO4): Acta Academiae Medicinae Sinicae      Editor in chief: Xuetao CAO

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Acta Academiae Medicinae Sinicae ›› 2025, Vol. 47 ›› Issue (4) : 666-672. DOI: 10.3881/j.issn.1000-503X.16354
Case Reports

Acute Hepatitis E Complicated With Liver Fibrosis:Report of One Case

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Abstract

Hepatitis E is the liver inflammation caused by a hepatitis E virus infection.Immunocompetent patients with acute hepatitis E can spontaneously clear the infection,whereas immunosuppressed patients may not be able to clear the hepatitis E virus infection and develop chronic hepatitis.Most patients with hepatitis E are asymptomatic and present only with mild and persistent liver function abnormalities.This article reports a case of hepatitis E in an immunocompetent adult with elevated aminotransferases as the main manifestation.Hepatic fibrosis was detected by hepatic puncture biopsy.This report aims to remind other physicians to evaluate liver fibrosis when encountering acute hepatitis E,especially in patients with chronic liver disease.

Key words

hepatitis E / liver fibrosis / abdominal CT / liver histology

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Xinyue LIU , Huiying RAO , Rui HUANG. Acute Hepatitis E Complicated With Liver Fibrosis:Report of One Case[J]. Acta Academiae Medicinae Sinicae. 2025, 47(4): 666-672 https://doi.org/10.3881/j.issn.1000-503X.16354

References

[1]
陈星月, 张玮. 戊型肝炎临床研究进展[J]. 中华医院感染学杂志, 2025, 35(7):1108-1114.DOI:10.11816/cn.ni.2025-241170.
[2]
Li P, Liu J, Li Y, et al. The global epidemiology of hepatitis E virus infection:a systematic review and meta-analysis[J]. Liver Int, 2020, 40(7):1516-1528.DOI:10.1111/liv.14468.
[3]
Kamar N, Garrouste C, Haagsma EB, et al. Factors associated with chronic hepatitis in patients with hepatitis E virus infection who have received solid organ transplants[J]. Gastroenterology, 2011, 140(5):1481-1489.DOI:10.1053/j.gastro.2011.02.050.
[4]
Roth D, Bloom RD, Molnar MZ, et al. KDOQI US commentary on the 2018 KDIGO clinical practice guideline for the prevention,diagnosis,evaluation,and treatment of hepatitis C[J]. Am J Kidney Dis, 2020, 75(5):665-683.DOI:10.1053/j.ajkd.2019.12.016.
[5]
Kamar N, Bendall R, Legrand-Abravanel F, et al. Hepatitis E[J]. Lancet, 2012, 379(9835):2477-2488.DOI:10.1016/S0140-6736(11)61849-7.
[6]
Legrand-Abravanel F, Thevenet I, Mansuy JM, et al. Good performance of immunoglobulin M assays in diagnosing genotype 3 hepatitis E virus infections[J]. Clin Vaccine Immunol, 2009, 16(5):772-774.DOI:10.1128/CVI.00438-08.
[7]
European Association for the Study of the Liver. EASL clinical practice guidelines on hepatitis E virus infection[J]. J Hepatol, 2018, 68(6):1256-1271.DOI:10.1016/j.jhep.2018.03.005.
[8]
Kamar N, Selves J, Mansuy JM, et al. Hepatitis E virus and chronic hepatitis in organ-transplant recipients[J]. N Engl J Med, 2008, 358(8):811-817.
[9]
Dalton HR, Bendall RP, Keane FE, et al. Persistent carriage of hepatitis E virus in patients with HIV infection[J]. N Engl J Med, 2009, 361(10):1025-1027.DOI:10.1056/NEJMc0903778.
[10]
Geng Y, Zhang H, Huang W, et al. Persistent hepatitis E virus genotype 4 infection in a child with acute lymphoblastic leukemia[J]. Hepat Mon, 2014, 14(1):e15618.DOI:10.5812/hepatmon.15618.
[11]
Pischke S, Peron JM, von Wulffen M, et al. Chronic hepatitis E in rheumatology and internal medicine patients:a retrospective multicenter european cohort study[J]. Viruses, 2019, 11(2):186.DOI:10.3390/v11020186.
[12]
Mallet V, Bruneau J, Zuber J, et al. Hepatitis E virus-induced primary cutaneous CD30(+)T cell lymphoproliferative disorder[J]. J Hepatol, 2017, 67(6):1334-1339.DOI:10.1016/j.jhep.2017.08.011.
[13]
Kraef C, Schlein C, Hiller J, et al. Course of HEV viremia and anti-HEV IgM/IgG response in asymptomatic blood donors[J]. J Clin Virol, 2018, 105:26-30.DOI:10.1016/j.jcv.2018.05.013.
[14]
Dalton HR, Fellows HJ, Stableforth W, et al. The role of hepatitis E virus testing in drug-induced liver injury[J]. Aliment Pharmacol Ther, 2007, 26(10):1429-1435.DOI:10.1111/j.1365-2036.2007.03504.x.
[15]
Davern TJ, Chalasani N, Fontana RJ, et al. Acute hepatitis E infection accounts for some cases of suspected drug-induced liver injury[J]. Gastroenterology, 2011, 141(5):1665-1672.e9.DOI:0.1053/j.gastro.2011.07.051.
[16]
Lenggenhager D, Weber A. An update on the clinicopathologic features and pathologic diagnosis of hepatitis E in liver specimens[J]. Adv Anat Pathol, 2018, 25(4):273-281.DOI:10.1097/PAP.0000000000000195.
[17]
Lenggenhager D, Pawel S, Honcharova-Biletska H, et al. The histologic presentation of hepatitis E reflects patients’ immune status and pre-existing liver condition[J]. Mod Pathol, 2021, 34(1):233-248.DOI:10.1038/s41379-020-0593-1.
[18]
Schulz M, Choi M, Bachmann F, et al. Shear wave elastography-based liver fibrosis assessment in patients with chronic hepatitis E displays elevated liver stiffness regardless of previous antiviral therapy[J]. Quant Imaging Med Surg, 2022, 12(7):3528-3538.DOI:10.21037/qims-21-1178.
[19]
Viera-Segura O, Realpe-Quintero M, Panduro A, et al. First detection of hepatitis E virus genotype 3 as a common infectious agent in patients with chronic liver damage in Mexico[J]. Ann Hepatol, 2019, 18(4):571-577.DOI:10.1016/j.aohep.2019.03.005.
[20]
Shah SM, Baniya JB, Gupta BP, et al. Short article:association between liver fibrosis and hepatitis E seroprevalence among HIV-positive individuals in Nepal[J]. Eur J Gastroenterol Hepatol, 2019, 31(4):503-505.DOI:10.1097/MEG.0000000000001308.
[21]
俞傲, 吕维富, 周春泽, 等. 肝窦阻塞综合征CT和MRI表现[J]. 中国介入影像与治疗学, 2020, 17(4):220-223.DOI:10.13929/j.issn.1672-8475.2020.04.007.
[22]
Li X, Yang X, Xu D, et al. Magnetic resonance imaging findings in patients with pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome[J]. Clin Gastroenterol Hepatol, 2017, 15(6):955-957.DOI:10.1016/j.cgh.2017.01.009.
[23]
Lampichler K, Semmler G, Wöran K, et al. Imaging features facilitate diagnosis of porto-sinusoidal vascular disorder[J]. Eur Radiol, 2023, 33(2):1422-1432.DOI:10.1007/s00330-022-09132-4.
[24]
Liu F, Rong X, Guo H, et al. Clinical characteristics,CT signs,and pathological findings of pyrrolizidine alkaloids-induced sinusoidal obstructive syndrome:a retrospective study[J]. BMC Gastroenterol, 2020, 20(1):30.DOI:10.1186/s12876-020-1180-0.
[25]
赵紫园, 赵又瑾, 陈卫霞, 等. 病例分析:肝窦阻塞综合征的影像学征象[J]. 中国普外基础与临床杂志, 2024, 31(5):571-574.DOI:10.7507/1007-9424.202309095.
[26]
贾翠宇, 赵大伟, 冯骥良, 等. 肝窦阻塞综合征的临床和影像学表现[J]. 临床放射学杂志, 2022, 41(2):284-288.DOI:10.13437/j.cnki.jcr.2022.02.028.
[27]
Lu F, Jia S, Lu H, et al. Primary Budd-Chiari syndrome versus sinusoidal obstruction syndrome:a review[J]. Curr Med Res Opin, 2024, 40(2):303-313.DOI:10.1080/03007995.2023.2288909.
[28]
Camera L, Mainenti PP, Di Giacomo A, et al. Triphasic helical CT in Budd-Chiari syndrome:patterns of enhancement in acute,subacute and chronic disease[J]. Clin Radiol, 2006, 61(4):331-337.DOI:10.1016/j.crad.2005.12.001.
[29]
Shukla A, Shreshtha A, Mukund A, et al. Budd-Chiari syndrome:consensus guidance of the Asian Pacific Association for the study of the liver(APASL)[J]. Hepatol Int, 2021, 15(3):531-567.DOI:10.1007/s12072-021-10189-4.
[30]
邹高伟, 张亚林, 廖荣信. 肝脏结核的CT表现[J]. 中国现代医学杂志, 2013, 23(36):81-86.
[31]
Pischke S, Hardtke S, Bode U, et al. Ribavirin treatment of acute and chronic hepatitis E:a single-centre experience[J]. Liver Int, 2013, 33(5):722-726.DOI:10.1111/liv.12114.
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