Epidemiology and clinical features of sporadic hepatitis E as compared with hepatitis A

OBJECTIVES: To compare the epidemiology and clinical features of two enterically transmitted hepatitis, namely hepatitis E and hepatitis A. METHODS: We analyzed clinical features and risk factors of 105 cases of hepatitis A and 24 cases of hepatitis E admitted in 2002. All patients were tested positive for IgM antibody against either hepatitis A virus (HAV) or hepatitis E virus (HEV), and all patients were tested to be negative for IgM anti-HBV or IgG anti-HCV. RESULTS: Hepatitis A patients were significantly younger (median age = 27 yr) and most had a recent history of shellfish consumption, whereas hepatitis E patients were older (median age = 53 yr) and most had a recent travel history. Whereas hepatitis A was milder and recovery was uneventful, hepatitis E was more severe, associated with significant mortality and frequently complicated by protracted coagulopathy and cholestasis. CONCLUSIONS: Hepatitis E is a more severe disease entity as compared with hepatitis A and significant proportion of them are imported cases from an endemic area.