VIRAL HEPATITIS E IN PLEVEN REGION – CLINICAL, LABORATORY AND EPIDEMIOLOGICAL CHARACTERISTICS

Abstract

Viral hepatitis E (VHE) is endemic in most countries nowadays. Our purpose was to analyze the characteristics of VHE in the Pleven region. Material and Methods: We performed a retrospective analysis of clinical, laboratory, and epidemiological data of 33 consecutive serologically confirmed cases of VHE treated in Clinic of Infectious Diseases at University Hospital – Pleven (2016-2019) (18 male – 56%, mean age 59±15 years). Statistical methods – t-test and χ2 test (for parametric and non-parametric distributions, respectively; P<0.05 was considered to be significant). Results: Totally 283 cases of hepatitis were treated in the Clinic (2016-2019) (cases of VHE- 12%). Fifty-five percent of VHE cases were older than sixty years (79% – urban residents); 39% acquired the disease during March-April. Only in two cases had contacts with pigs. The commonest symptoms were hepatomegaly (100%), fatigue (94%), darkness of urine (92%), jaundice (79%), anorexia (76%), splenomegaly (67%), nausea and vomiting (58%). The jaundice was protracted (median six days). Laboratory investigations- mild leukocytosis (21%), thrombocytopenia (18%), increased serum bilirubin with a prevalence of direct fraction (82%; mean ± sd 94±91 µmol/L; 95% CI 63÷125), increased aminotransferases in 100% (ASAT mean ± sd 812±629 IU/L; 95% CI 598÷1027; ALAT mean ± sd 1327± 790 IU/L; 95% CI 1058÷1597), mild to moderately increased alkaline phosphatase and GGT (90% and 100%, respectively). All of the patients were successfully treated with glucose infusions, hepatoprotective drugs and vitamins (mean 10 days). Conclusions: The clinicians should consider VHE in the diagnostic process. The disease affects mainly older ages, and jaundice is protracted.