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Am J Trop Med Hyg 1998 Mar;58(3):330-334
Role of Hepatitis E virus in sporadic cases of acute and fulminant
hepatitis in an endemic area (Chad).
Coursaget P, Buisson Y, N'Gawara MN, Van Cuyck-Gandre H, Roue R
Institut de Virologie de Tours and Laboratoire d'Immunologie des Maladies Infectieuses,
Faculte de Pharmacie, France.
Forty-one patients with acute or fulminant hepatitis and 86 control patients
were entered into a study of sporadic, acute, and fulminant hepatitis in the
N'Djamena area of Chad in 1993. Acute Hepatitis B was diagnosed in nine (22%)
patients and acute Hepatitis E in 27 (66%) patients. No acute Hepatitis A was
observed and 10% of the patients had serologic markers of Hepatitis C virus
(HCV) infection. Dual acute Hepatitis B and E were observed in four patients
(10%) and acute HEV infection was associated with chronic Hepatitis B surface
antigen carriage in 16 (39%). Epidemiologic findings concerning HBV from Chad
suggest that these patients had undiagnosed chronic liver disease due to HBV,
with acute deterioration caused by superimposed HEV replication. Moreover, it
is obvious that in developing countries only the most severe cases of hepatitis
are seen in hospital settings and a large proportion of them are related to
superinfection with HBV and HEV. Antibody to HEV was observed in 22% of the
control patients. This observation and the fact that epidemic and sporadic cases
of HEV are observed in Chad indicates that HEV is highly endemic in this country.
PMID: 9546413, UI: 98206489
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