SHM Converge Scientific Abstract ePoster Gallery-Intersecting Challenges: Hepatitis E Infection in the Context of Alcoholic Cirrhosis

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This case highlights hepatitis E virus (HEV) as an underrecognized cause of acute liver injury, especially in patients with underlying liver disease. A 39-year-old man with alcohol use disorder presented with jaundice, fatigue, poor appetite, altered mental status, and dark urine. He was diagnosed with decompensated alcoholic hepatitis and hepatic encephalopathy, treated with lactulose and steroids, and evaluated for viral hepatitis. HEV IgM later returned positive, indicating acute or recent HEV infection. He improved clinically and was discharged to inpatient rehabilitation with hepatology follow-up.<br /><br />The discussion emphasizes that HEV is often associated with pregnancy, immunocompromised states, and chronic liver disease, but it may also be important in alcohol-related cirrhosis. In the United States, HEV genotype 3 is the most common strain and has an estimated seroprevalence of 6%. Patients with alcohol-related cirrhosis may be up to 14 times more likely to acquire HEV than healthy controls and three times more likely than patients with cirrhosis from other causes.<br /><br />The mechanism for this increased susceptibility is not fully understood, but likely involves cirrhosis-related immune dysfunction and alcohol-induced liver injury. HEV co-infection may worsen liver disease progression, prognosis, and mortality in cirrhotic patients.<br /><br />Overall, this case underscores the need to consider HEV in patients with alcoholic cirrhosis and to monitor at-risk patients closely, as co-infection can significantly affect outcomes and management.

Asset Subtitle

Griffin R. Perry

Meta Tag

Author List Griffin R. Perry, Rohit Jain

Category Clinical Vignettes

Concept Hepatitis E

Concept Acute Hepatocellular Injury

Concept Alcoholic Cirrhosis

Concept HEV IgM

Concept Underlying Liver Disease

Distinguished Non-Finalist

Presenter Organization Penn State College of Medicine

Presenting Author Griffin R. Perry

Track Adult

Keywords

hepatitis E virus

HEV

acute liver injury

alcoholic cirrhosis

decompensated alcoholic hepatitis

hepatic encephalopathy

HEV IgM

liver disease

viral hepatitis

co-infection

Hepatitis E

Acute Hepatocellular Injury

Alcoholic Cirrhosis

HEV IgM

Underlying Liver Disease