Poster (15W183)

Is hepatitis E becoming more common Northern Ireland than hepatitis A?

Author(s)

Gordon K, McCaughey C*, Coyle P*, Cash WJ, McDougall NI

Department(s)/Institutions

Liver Unit and Regional Virology Laboratory*, Royal Victoria Hospital, Belfast

Introduction

Detection of Hepatitis E ( HEV) is increasing across the UK with 884 confirmed cases in England in 2014 compared to 274 in 2010 (1). It is not a notifiable condition in Ireland. Hepatitis E is transmitted via the faecal-oral route, with the largest rise noted in cases of presumed zoonotic route via the food chain. The illness is usually mild and self limiting but can occasionally progress to fulminant hepatitis.

Aims/Background

Our aims were twofold. Firstly to analyse data from the single regional virology laboratory for NI and determine if the number of positive HEV tests is increasing year on year; and secondly to identify trends within the data that may inform decisions on recommendations for HEV testing in NI.

Method

A retrospective analysis was performed on all HEV tests performed between January 2010 and July 2015. The data was grouped into 10 year age increments, sex and source of referral. If multiple tests were sent for the same person the first test was included and any replicas removed.

Hepatitis A (HAV) results for the same time period where also analysed to provide context for the HEV results. Any positive HAV IgM’s were checked with PCR results leaving true positives only.

Results

* only 7 months from January- July 2015

In 2012 all HEV positive tests were in females >40 years old. In 2013 and 2014 all positive test results were in Males >50 years old. The most common reason for testing was “deranged lfts”.

Conclusions

Both testing and detection of HEV is rising in Northern Ireland. There were more positive HEV tests than HAV despite 30 times more HAV tests being sent over 5 years. We suggest HEV testing anyone presenting with jaundice and hepatitis, deranged LFT’s following overseas travel or hepatitis with negative liver screen.