Fraga M, et al. – This study focused on hepatitis E virus as a cause of acute hepatitis acquired in Switzerland. As per nucleic acid–based diagnosis, HEV seemed a relevant cause of acute hepatitis in Switzerland. Symptomatic patients in majority included middle–aged and elderly men. Researchers recommended including testing for HEV early in the diagnostic workup of acute hepatitis and of neuralgic amyotrophy, a typical extrahepatic manifestation of HEV genotype 3 infection.

Methods

• A molecular testing to identify and characterize acute hepatitis E acquired in Switzerland was implemented.

Results

• From November 2011 and December 2016, researchers identified documentation of 93 cases of mostly symptomatic acute hepatitis E acquired in Switzerland.
• In this study, median HEV RNA was 7.5 x 10⁴ IU/ml (range, 5.3 to 4.7 x 10⁷ IU/ml).
• Successful HEV genotyping was observed in 78 patients, this revealed genotype 3 in 75 and genotype 4 in 3 patients.
• As per phylogenetic analyses, a few limited geographial and temporal clusters were evident.
• Anti–HEV IgM serology was available of 91 patients; 4 were negative; three of these were also IgG–negative, likely as a result of immunosuppression, and one was IgG positive, a constellation compatible with HEV reinfection.
• In this study, median age was 58 years (range, 20–80 years); 71 (76.3%) were men and 49 of these (69.0%) were ≥50 years old.
• Patients with underlying chronic liver disease had severe clinical course; fatal outcomes were observed in two patients.
• They identified six patients (6.5%) with neuralgic amyotrophy.