Srpski arhiv za celokupno lekarstvo 2016 Volume 144, Issue 1-2, Pages: 63-68
https://doi.org/10.2298/SARH1602063B
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Epidemiological characteristics and clinical manifestations of hepatitis E virus infection in Bulgaria: A report on 20 patients
Baymakova Magdalena (Military Medical Academy, Department of Infectious Diseases, Sofia, Bulgaria)
Sakem Benjamin (Center for Laboratory Medicine Dr. Risch, Department of Bacteriology, Bern, Switzerland)
Plochev Kamen (Military Medical Academy, Department of Infectious Diseases, Sofia, Bulgaria)
Popov Georgi T. (Military Medical Academy, Department of Infectious Diseases, Sofia, Bulgaria)
Mihaylova-Garnizova Raynichka (Military Medical Academy, Department of Infectious Diseases, Sofia, Bulgaria)
Kovaleva Valentina (Military Medical Academy, Center of Military Epidemiology and Hygiene, Sofia, Bulgaria)
Kundurdjiev Todor (Medical University, Faculty of Public Health, Department of Occupational Health, Sofia, Bulgaria)
Introduction. Hepatitis E is one of the leading clinical manifestations of
acute viral hepatitis in developing countries. In industrialized countries,
during the past several years, sporadic “autochthonous” cases of HEV
infection have been increased. Objective. The aim of this study was to
analyze the epidemiological, clinical and laboratory features of HEV
infection among patients hospitalized at the Department of Infectious
Diseases in Military Medical Academy, Sofia, Bulgaria. Methods. A
retrospective study of 806 cases of acute viral hepatitis was performed at
the Department of Infectious Diseases in Military Medical Academy, Sofia,
Bulgaria, between December 2004 and September 2012. The etiological diagnosis
was established by ELISA. The statistical analysis was performed using Excel
2007 (Microsoft, Redmond, Washington, USA) and SPSS Statistics 19.0 (IBM
Corp., Armonk, New York, USA). Results. Specific reaction to anti-HEV-IgM and
anti-HEV-IgG antibodies were detected in 20 (2.48%) of 806 patients. The most
observed clinical presentations were jaundice (85%), fatigue (85%), anorexia
(65%), abdominal discomfort (55%) and fever (40%). The mean values of
aspartate transaminase and alanine transaminase were 521 IU/l and 881 IU/l,
respectively. The cholestasis was slight, marked with mean values of
gamma-glutamyl transferase and alkaline phosphatase, respectively 418 IU/l
and 486 IU/l. Conclusion. We report twenty autochthonous sporadic cases of
acute infection with HEV. The zoonotic etiology of the virus as well as the
foodborne transmission of the infection is discussed. We found that aging and
pre-existing underlying diseases are risk factors for a severe course of the
HEV infection.
Keywords: autochthonous HEV infection, clinical course, biochemical parameters