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Acute hepatitis E in Montenegro: Epidemiology, clinical and laboratory features

Dragica Terzic, Brankica Dupanovic, Boban Mugosa, Nenad Draskovic, Neda Svirtlih

Abstract

Objective. To evaluate the incidence, demographic, clinical and laboratory characteristics of patients with acute viral hepatitis E in Montenegro. Material and methods. A total of 400 patients with acute viral hepatitis from January 1st, 2000 to December 31st, 2007 were enrolled in the study. Serological tests for hepatitis A, B, C, D, and E viruses, Epstein-Barr virus, cytomegalovirus, and herpes simplex viruses were performed. Standard laboratory tests for liver function were analyzed. The results are presented as absolute numbers, mean ± SD, range of values, and percent. A P value < 0.05 was considered significant. Results. Twenty-four (6%) patients had clinically and/or serologically confirmed acute hepatitis E. The mean age of the patients was 25 ± 6 years; 62.5% were males. The majority of the patients (66%) belonged to the 20 to 40 yrs age group (P < 0.05). Seven patients were asymptomatic. Foremost symptoms were loss of appetite (100%), fatigue (94%) and vomiting (75%). The most frequent clinical sign was mild to moderate liver enlargement (94%). Jaundice had 12/17 symptomatic patients. Elevation of alanine aminotransferase was found in 19 patients including two patients without symptoms. The enzyme, gamma glutamyltranspeptidase was increased in all patients. Conclusion. Acute hepatitis E in Montenegro emerges as an autochthonous infection with a low incidence. Sub-clinical and anicteric infections may occur. Elevation of gamma glutamyltranspeptidase is an important parameter of the biochemical profile of the disease.

Key words. Hepatitis E virus, Acute hepatitis, Epidemiology, Gamma glutamyltranspeptidase, Montenegro

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The Official Journal of the Mexican Association of Hepatology, the Latin-American Association for the Study of the Liver and the Canadian Association for the Study of the Liver

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