Observational studyHepatology (Baltimore, Md.)2016
The role of hepatitis E virus infection in adult Americans with acute liver failure.
Observational study in Hepatology (Baltimore, Md.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00518440 (A Multi-Center Trial to Study Acute Liver Failure in Adults), which is not on this map. Cited by 23 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Multi-Center Trial to Study Acute Liver Failure in Adults
Who cites it
23 citing papers in PubMed, 68 citations in OpenAlex.
- Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative Review.Pathogens (Basel, Switzerland) · 2025Review
- Differentiating Ischemic Hepatitis from Acetaminophen Overdose in Acute Liver Failure: Role of Acetaminophen Adducts-Ischemic Hepatitis vs Acetaminophen Overdose.Digestive diseases and sciences · 2024Article
- Misdiagnosed Antibiotic-Induced Liver Injury: Unveiling Acute Hepatitis E in a 65-Year-Old Patient.The American journal of case reports · 2024Article
- Profile of clinical characteristics and serologic markers of sporadic hepatitis E in a community cohort study.Emerging microbes & infections · 2023Article
- Fulminant Hepatitis A and E Co-infection Leading to Acute Liver Failure: A Case Report.Cureus · 2023Article
- Hepatitis E in immunocompromised individuals.World journal of hepatology · 2022Review
- Present and future management of viral hepatitis.World journal of gastroenterology · 2021Review
- From hepatitis A to E: A critical review of viral hepatitis.World journal of gastroenterology · 2021Review
- An Approach to Drug-Induced Liver Injury from the Geriatric Perspective.Current gastroenterology reports · 2021Review
- Hepatitis E Virus Superinfection: an Underrecognized Trigger of Acute Hepatitis B Virus Flare.Cureus · 2021Article
- Seroprevalence of hepatitis E virus antibodies in adults and children from upstate New York: A cross-sectional study.PloS one · 2021Article
- Role of Hepatitis E Virus Infection in North American Patients With Severe Acute Liver Injury.Clinical and translational gastroenterology · 2020Observational
- Acute Liver Failure (ALF) in Pregnancy: How Much Is Pregnancy Related?Hepatology (Baltimore, Md.) · 2020Article
- Viral Hepatitis E and Chronicity: A Growing Public Health Concern.Frontiers in microbiology · 2020Review
- Acute liver failure.Lancet (London, England) · 2019Review
- The Clinical Perspective on Hepatitis E.Viruses · 2019Review
- Acute and Persistent Hepatitis E Virus Genotype 3 and 4 Infection: Clinical Features, Pathogenesis, and Treatment.Cold Spring Harbor perspectives in medicine · 2019Review
- Acute Liver Failure of Indeterminate Etiology: A Comprehensive Systematic Approach by An Expert Committee to Establish Causality.The American journal of gastroenterology · 2018Article
- Role of Hepatitis E Virus Infection in Acute-on-Chronic Liver Failure.BioMed research international · 2018Review
- The Enigma of Hepatitis E Virus.Gastroenterology & hepatology · 2017Article
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 1 country.
Funding
Abstract
Acute hepatitis E virus (HEV) infection is a leading cause of acute liver failure (ALF) in many developing countries, yet rarely identified in Western countries. Given that antibody testing for HEV infection is not routinely obtained, we hypothesized that HEV-related ALF might be present and unrecognized in North American ALF patients. Serum samples of 681 adults enrolled in the U.S. Acute Liver Failure Study Group were tested for anti-HEV immunoglobulin (Ig) M and anti-HEV IgG levels. Subjects with a detectable anti-HEV IgM also underwent testing for HEV RNA. Mean patient age was 41.8 years, 32.9% were male, and ALF etiologies included acetaminophen (APAP) hepatotoxicity (29%), indeterminate ALF (23%), idiosyncratic drug-induced liver injury DILI (22%), acute hepatitis B virus infection (12%), autoimmune hepatitis (12%), and pregnancy-related ALF (2%). Three men ages 36, 39, and 70 demonstrated repeatedly detectable anti-HEV IgM, but all were HEV-RNA negative and had other putative diagnoses. The latter 2 subjects died within 3 and 11 days of enrollment whereas the 36-year-old underwent emergency liver transplantation on study day 2. At admission, 294 (43.4%) of the ALF patients were anti-HEV IgG positive with the seroprevalence being highest in those from the Midwest (50%) and lowest in those from the Southeast (28%). Anti-HEV IgG
conclusionAcute HEV infection is very rare in adult Americans with ALF (i.e., 0.4%) and could not be implicated in any indeterminate, autoimmune, or pregnancy-related ALF cases. Past exposure to HEV with detectable anti-HEV IgG was significantly more common in the ALF patients compared to the general U.S. POPULATION: (Hepatology 2016;64:1870-1880).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.