Superinfection of hepatitis E as a factor in the development of acute hepatic encephalopathy on the background of HBV-cirrhosis of the liver

• Main Authors: S V Baramzina, O N Lyubeznova, A L Bondarenko, A V Protasov
• Format: Article
• Language: Russian
• Published: "Consilium Medicum" Publishing house 2018-02-01
• Series: Терапевтический архив
• Subjects: acute autochthonous hepatitis e; hbv-cirrhosis; acute hepatic encephalopathy
• Online Access: https://ter-arkhiv.ru/0040-3660/article/viewFile/32865/pdf

The article presents an analysis of the clinical case of superinfection of autochthonous acute hepatitis E against the background of HBV-cirrhosis of the liver. HEV infection was diagnosed in a 39 year old man who did not travel outside the region and the country for a long time and used unboiled water. The peculiarity of the disease in the non-endemic region was: a severe course of hepatitis E against the background of HBV etiology, with the development of the clinic for acute hepatic insufficiency and encephalopathy, the presence of severe cytolysis syndrome, cholestasis, hepatic-cell insufficiency and prolonged convalescence. Timely treatment of the patient for medical aid and intensive pathogenetic therapy of hepatit-E superinfection with compensated HBV-cirrhosis allowed to save the patient's life. However, the prognosis for the patient's later life is unfavorable, due to submissive liver necrosis and the risk of rapid decompensation of cirrhosis. When deciphering undifferentiated in Russia acute hepatitis in persons with cirrhosis of another etiology (viral, alcoholic, medicinal), it is necessary to include the definition of HEVRNA and HEV IgM and G. in the survey design.