Skip to Main content Skip to Navigation
Journal articles

Hepatitis E virus infection and acute-on-chronic liver failure in West Africa: a case-control study from The Gambia

Abstract : Background: In sub-Saharan Africa, it is unknown whether hepatitis E virus (HEV) infection is a common precipitating event of acute-on-chronic liver failure (ACLF). Aims: To estimate the prevalence of HEV infection in general population and assess whether HEV is a common trigger of ACLF in cirrhotic patients in The Gambia, West Africa. Methods: We first conducted an HEV sero-survey in healthy volunteers. We then tested cirrhotic patients with ACLF (cases) and compensated cirrhosis (controls) for anti-HEV IgG as a marker of exposure to HEV, and anti-HEV IgA and HEV RNA as a marker of recent infection. We also described the characteristics and survival of the ACLF cases and controls. Results: In the healthy volunteers (n = 204), 13.7% (95% CI: 9.6-19.2) were positive for anti-HEV IgG, and none had positive HEV viraemia. After adjusting for age and sex, the following were associated with positive anti-HEV IgG: being a Christian, a farmer, drinking water from wells, handling pigs and eating pork. In 40 cases (median age: 45 years, 72.5% male) and 71 controls (39 years, 74.6% male), ≥70% were infected with hepatitis B virus. Although hepatitis B flare and sepsis were important precipitating events of ACLF, none had marker of acute HEV. ACLF cases had high (70.0%) 28-day mortality. Conclusions: Hepatitis E virus infection is endemic in The Gambia, where both faecal-oral route (contaminated water) and zoonotic transmission (pigs/pork meat) may be important. However, acute HEV was not a common cause of acute-on-chronic liver failure in The Gambia.
Document type :
Journal articles
Complete list of metadatas

https://hal-pasteur.archives-ouvertes.fr/pasteur-02875297
Contributor : Yusuke Shimakawa <>
Submitted on : Friday, June 19, 2020 - 3:40:41 PM
Last modification on : Friday, June 26, 2020 - 3:15:17 AM

Links full text

Identifiers

Collections

Citation

Yusuke Shimakawa, H. Njai, K. Takahashi, L. Berg, G. Ndow, et al.. Hepatitis E virus infection and acute-on-chronic liver failure in West Africa: a case-control study from The Gambia. Alimentary Pharmacology & Therapeutics (Suppl), 2016, 43 (3), pp.375-384. ⟨10.1111/apt.13484⟩. ⟨pasteur-02875297⟩

Share

Metrics

Record views

40