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Viral hepatitis in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Hepatitis E causes acute hepatitis, just like hepatitis A. It is predominantly transmitted via the fecal–oral route, but less frequent mode of transmission has also been reported (ingestion of raw or undercooked shellfish, infrequently by blood products or blood transfusion).
Hepatitis E
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Acute hepatitis E is indistinguishable from other types of hepatitis and often comes with general malaise, myalgia and icterus. It can pass unnoticed, but in severe cases, ALT can rise to 40 × the upper limit or normal. Bilirubin and other markers of cholestasis are often slower to recover.
The liver, gallbladder and pancreas
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Dina G. Tiniakos, Alastair D. Burt
Hepatitis A virus characteristically produces a mild illness and full recovery occurs. Hepatitis B and C virus infections frequently result in chronic hepatitis, leading to cirrhosis and even hepatocellular carcinoma. Hepatitis D synergizes with hepatitis B to produce more severe disease. Hepatitis E infection generally resolves after a mild illness but pregnant women sometimes develop life-threatening liver failure and immunocompromised patients may develop chronic hepatitis. A summary of the main hepatitis viruses is provided in Table 11.2.
Acute hepatitis E in an immunocompromised patient with seropositive rheumatoid arthritis on rituximab and long-term methotrexate
Published in Modern Rheumatology Case Reports, 2021
Bryan Dalton, Gaye Cunnane, Richard Conway
Hepatitis E virus (HEV) was first detected as a nonA–nonB cause of acute hepatitis in the 1980s in developing countries, and is now the most common cause of acute hepatitis globally [1]. HEV infection is increasingly detected in western civilisation in immunosuppressed individuals, primarily post-transplant patients or those with haematological malignancies [2,3]. However, there has been increased recognition of hepatitis E in those who are immunocompromised for autoimmune conditions [4]. This is concerning particularly as there is growing evidence of autochthonous HEV infection in developed countries and new endemic areas in recent years, such as southwest France [5]. HEV3 is the most commonly recognised genotype in developed countries, with evidence of enteric zoonotic transmission from pig, wild boar, deer and mongoose [6].
Hepatitis E should be a global public health priority: recommendations for improving surveillance and prevention
Published in Expert Review of Vaccines, 2020
Carl D Kirkwood, Katherine R Dobscha, A Duncan Steele
Hepatitis E virus (HEV) is an important cause of enterically transmitted viral hepatitis and contributes to over 50% of the acute viral hepatitis cases in endemic areas [1]. A World Health Organization (WHO)-funded modeling study estimated that 20 million people were infected with HEV in 2005, with estimated 3.3 million clinical cases, up to 70,000 deaths, and 3000 stillbirths, mostly in Asia and Africa [2], causing 3.3% of all deaths from viral hepatitis worldwide [3]. HEV accounted for 1.7% of the total global healthy years of life lost (738,508 disability-adjusted life years) due to hepatitis in 2017 [4]. The most affected populations are among the world’s most vulnerable groups – pregnant women and their neonates, as well as displaced persons and those living in resource-limited settings with poor access to clean water and sanitation. HEV is a significant contributor to global maternal mortality, with reported case-fatality rates (CFRs) of 20–30% in pregnant women with the symptomatic disease [5,6]. In industrialized countries, HEV is a growing concern particularly in immunocompromised individuals and patients with chronic liver disease are also at risk for the severe disease after HEV infection [7,8]. However, given the lack of appropriate surveillance or outbreak investigations, these data are very likely significantly under-reported.
Nanoparticle-based immunotherapy: state of the art and future perspectives
Published in Expert Review of Clinical Immunology, 2020
Mario Di Gioacchino, Claudia Petrarca, Alessia Gatta, Gilda Scarano, Anila Farinelli, Loredana Della Valle, Arianna Lumaca, Pietro Del Biondo, Roberto Paganelli, Luca Di Giampaolo
The application of NPs in diagnostic and therapy is now a reality. In diagnostics, NPs are used as vehicles that deliver specifically contrast agents, leading to overcome the present limitations. The ability to incorporate drugs into nanosystems allows cell-targeted drug delivery to specific cells and/or organs [4–10]. Cancer diagnostics and therapy have particularly benefited from these new possibilities. There are many FDA and EMA approved NP-based treatments for cancer and several reported clinical trials [139,140]. Vaccination for infectious diseases is another area of application of NP-based treatment. NP-based vaccines for HBV are already used in clinical setting (36), NP-based vaccines for HPV are reducing HPV-induced cancers by 50% (37). NP-based vaccine for malaria has a reported efficacy rate as high as 50% in young children in the endemic area of sub-Saharan Africa (35). In China, an NP-based vaccine for hepatitis E virus has been licensed [141].