CASES OF FULMINANT HEPATITIS Е
Studies of hepatitis E (hepE) in hyperendemic regions have always been focused on the fulminant course of infection in pregnant women. Today, the number of autochthonous (non-imported, local) hepE cases in industrialized countries is increased. The frequency of fulminant hepatitis E is determined to vary from 1 to 4%. Despite numerous studies, there is still no clear understanding of the mechanisms leading to severe liver failure and fatal outcome. Reported cases of fulminant hepatitis associated with hepatitis E virus in Russia are rare. The mechanism that determines the severity of hepatitis E in the elder patients in non-endemic regions needs to be clarified. In our opinion, it is not always possible to establish a causal link between acute hepatitis E, concomitant liver disease and death of the patient. However, the existence of cases of fulminant hepatitis E, described in this paper, requires attention of clinicians to this problem. It is important to include testing for serological markers of hepatitis E virus infection (anti-HEV IgM and IgG, HEV RNA) for patients with liver disease in the current diagnostic algorithms.