Journal
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY
Volume 20, Issue 8, Pages 800-803Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MEG.0b013e3282f1cbff
Keywords
autochthonous; chronic liver disease; hepatitis E; superinfection; zoonosis
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Hepatitis E virus is endemic in many parts of the developing world and causes a self-limiting hepatitis in young adults, except in pregnant women and patients with chronic liver disease, where the mortality is high. Locally acquired hepatitis E is increasingly recognized in the developed world. It is caused by hepatitis E virus genotype 3, affects the middle-aged and the elderly, and may be a zoonotic infection from pigs. We present a case of locally acquired hepatitis E infection in a patient with previously undiagnosed cirrhosis, which resulted in subacute liver failure and death. We describe our attempt to trace this infection to a free-range pig farm adjacent to the patient's place of employment. Hepatitis E infection should be considered in the differential diagnosis in patients with decompensated chronic liver disease whatever their age or travel history. When found, the prognosis may be poor.
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