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Moniek van Heijst, Assi Cabbolet, Dennis van der Lee, Robbert Eichhorn, Ulrike de Wit, Robert Laheij
Background: Evidence suggests that the incidence of hepatitis E infection increases in the developed world, and that the infection is not always travel related. The details of acute infections in developed countries have not yet been fully elucidated. Objectives: The aim of this study was to evaluate clinical features of acute viral hepatitis E infections in the developed world. Study design: All patients with a positive result on hepatitis E serology testing in the previous 5 years were evaluated. Retrospectively, the files of patients with an acute infection were analyzed. Results: Overall, 332 patients were tested. In 34 patients there was an acute infection. None of the patients had travelled to a developing country. Three patients were asymptomatic. In the other patients, main symptoms were malaise, fatigue and nausea and/or vomiting. Jaundice was seen in 8 patients. Liver tests were increased in almost all patients, but ranges varied considerably. The infection was self-limiting in all cases; normalization of liver tests occurred after two months. Conclusions: Clinical features of acute hepatitis E infection are nonspecific and cannot be recognized at presentation. In patients with acute onset of malaise and elevation of liver tests, hepatitis E should be considered.