Acute hepatitis E virus infection in a migrant population in North East Italy : A retrospective analysis

Objective To study the epidemiological and clinical features of Hepatitis E Virus (HEV) infection in a migrant population. Methods We performed a retrospective chart review, identifying a cohort of 21 symptomatic patients of migrant origin with confirmed HEV infection admitted in the period between January 1995 - November 2014. Results 20 (95%) patients came from South Asian countries highly endemic for HEV, all positive for HEV genotype 1. Recent travel to a highly endemic country was the most consistent risk factor identified in 90% of cases, duration from return to Italy to hospitalisation ranged from 10 to120 days. Nausea and vomiting (100%), jaundice (95.2%), and anorexia (85.7%) were the most common reported symptoms. Fever was present in 57.1% of cases. Transaminase values were elevated in all patients and serum bilirubin was raised in 86% of patients. We found no statistically significant differences between clinical symptoms, laboratory results or duration of hospitalisation in patients with co-morbidities compared to those without. We also report a secondary case of HEV genotype 1 transmitted within Italy. Conclusion Our study highlights the epidemiological risk factors and clinical features of HEV infection in a migrant population in Italy and should stimulate further research regarding the prevalence and morbidity of HEV within migrant populations in Europe.