Universität zu Köln

Beer, Andrea, Holzmann, Heidemarie, Pischke, Sven, Behrendt, Patrick, Wrba, Fritz, Schlue, Jerome, Drebber, Uta, Neudert, Barbara, Halilbasic, Emina, Kreipe, Hans, Lohse, Ansgar, Sterneck, Martina, Wedemeyer, Heiner, Manns, Michael and Dienes, Hans P. (2019). Chronic Hepatitis E is associated with cholangitis. Liver Int., 39 (10). S. 1876 - 1884. HOBOKEN: WILEY. ISSN 1478-3231

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Abstract

Background and Aims Sporadic hepatitis E is an emerging indigenous disease in Europe induced by genotype 3 of the virus. While the disease takes an acute self-limited course in immunocompetent individuals, under immunocompromised conditions chronic hepatitis E might develop. The histology of chronic hepatitis E has not been described in detail systematically. Methods Liver biopsies from 19 immunosuppressed patients with chronic hepatitis E were collected: 17 were organ transplant recipients, one had a CD4-deficiency and one had received steroid therapy because of ulcerative colitis. Biopsies were processed with standard stains. Evaluation of histologic activity and fibrosis was performed according to Ishak. Additionally, immunohistochemistry with antibodies directed against open reading frame 2 and 3 of the virus was performed and liver biopsies were tested for hepatitis E virus RNA. Results Biochemical data showed an increase in alanine transaminase, aspartate transaminase, gamma-glutamyl transferase and total bilirubin. Histopathology displayed typical features of chronic hepatitis with mild to moderate activity. The number of polymorphonuclear leucocytes was considerably increased and all patients had a florid cholangitis that presented as a destructive form in five of them. Hepatocytes and bile duct epithelia stained positive for hepatitis E virus by immunohistochemistry. Conclusions Chronic hepatitis E in immunocompromised individuals runs a similar course as hepatitis B and C and shows similar histopathology. However, the presence of destructive cholangitis in some cases accompanied by an increased number of polymorphonuclear leucocytes is markedly different. Immunohistochemically the virus is present in bile duct epithelia, seemingly the cause for cholangitis.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Beer, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Holzmann, Heidemarie UNSPECIFIED UNSPECIFIED UNSPECIFIED Pischke, Sven UNSPECIFIED UNSPECIFIED UNSPECIFIED Behrendt, Patrick UNSPECIFIED UNSPECIFIED UNSPECIFIED Wrba, Fritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlue, Jerome UNSPECIFIED UNSPECIFIED UNSPECIFIED Drebber, Uta UNSPECIFIED UNSPECIFIED UNSPECIFIED Neudert, Barbara UNSPECIFIED UNSPECIFIED UNSPECIFIED Halilbasic, Emina UNSPECIFIED UNSPECIFIED UNSPECIFIED Kreipe, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Lohse, Ansgar UNSPECIFIED UNSPECIFIED UNSPECIFIED Sterneck, Martina UNSPECIFIED UNSPECIFIED UNSPECIFIED Wedemeyer, Heiner UNSPECIFIED UNSPECIFIED UNSPECIFIED Manns, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Dienes, Hans P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-133060
DOI:	10.1111/liv.14137
Journal or Publication Title:	Liver Int.
Volume:	39
Number:	10
Page Range:	S. 1876 - 1884
Date:	2019
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1478-3231
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language E VIRUS-INFECTION; LIVER CHIMERIC MICE; FULMINANT-HEPATITIS; T-CELLS; HEV; CIRRHOSIS; PATIENT; HIV; PREVALENCE; HISTOLOGY Multiple languages Gastroenterology & Hepatology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13306