Hepatitis E seroprevalence, cases and management in a large German centre for liver transplantation
Bibliographic record
Abstract
Abstract Background and Aims Hepatitis E virus (HEV) is an increasingly recognised pathogen in industrialised countries, in particular genotype 3. Patients with underlying liver disease are at increased risk for severe course of the infection. Additionally, patients receiving immunosuppressive therapy can develop chronic HEV infection, which may cause further liver damage and ultimately lead to cirrhosis, decompensation or death. Methods This retrospective study assessed 1023 patients on the waiting list for liver transplantation, of which 636 were transplanted, for conducted HEV diagnostics, courses of disease and management, in the time from 2007 to 2018. Viral loads and HEV genotypes were determined retrospectively for selected cases. Results We found a seroprevalence of 29.7%. Forty‐five patients (4.4%) seroconverted during the study period, indicating newly acquired infection. HEV replication was detected in nine patients (0.9%), seven of which were managed in our clinic and further analysed. Three of these patients were diagnosed with active HEV infection retrospectively. All patients with replicating HEV were liver‐transplanted and therefore treated with immunosuppressants; four developed chronic infection >3 months. Two patients were also diagnosed with graft rejection when they had active hepatitis E. Patients who received antiviral treatment with Ribavirin cleared the infection and normalised alanine aminotransferase (ALT) levels within few weeks. Conclusion The results argue for more and systematic HEV testing of liver‐transplanted patients, in routine settings and especially when ALT is elevated, as infections may be significantly underdiagnosed. Patients receiving immunosuppressive therapy who develop chronic infection can effectively be treated to prevent further liver damage.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".