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Microorganisms
Special Issues
Emerging Pathogens Causing Acute Hepatitis
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Emerging Pathogens Causing Acute Hepatitis

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: 15 June 2024 | Viewed by 13075

Special Issue Editors

Dr. Ibrahim M. Sayed

E-Mail Website
Guest Editor
Department of Biomedical & Nutritional Sciences, Zuckerberg College of Health Sciences, University of Massachusetts-Lowell, Lowell, MA, USA
Interests: viral hepatitis; new emerging pathogen; acute hepatitis of unknown etiology; pathogenesis; animal model
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Sayed F. Abdelwahab

E-Mail Website
Guest Editor
Department of Pharmaceutics and Industrial Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
Interests: viral hepatitis; HIV; dendritic cells; antimicrobial resistance mechanisms; hepatotropic pathogens
Dr. Ahmed El-Shamy

E-Mail Website
Guest Editor
Department of Master of Pharmaceutical Sciences (MPS), California Northstate University, Elk Grove, CA, USA
Interests: viral hepatitis; DAA; liver cancer; novel therapies; lipid metabolism; emerging infections
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Hepatitis A–E viruses are the major causes of acute hepatitis and acute liver failure globally. Still, some acute hepatitis cases are reported without identification of the causative agents/causes “named acute hepatitis of unknown etiology”. In April 2022, the WHO reported 10 cases from Scotland and 74 cases from the United Kingdom of acute hepatitis unknown etiology in children caused by new emerging pathogens: adenovirus and SARS-CoV-2. Still, some reported cases of acute hepatitis of unknown etiology are idiopathic. Therefore, the health alert is focused on the identification of unusual causes of acute hepatitis. Other pathogens are recorded with acute hepatitis, such as cytomegalovirus, Epstein Barr virus, Parvovirus B19, Coxiella burnetii, Coxsackie virus, etc. Further, coinfection between two hepatotropic pathogens is documented and highly affects the outcome of infection. The protocol of identification of acute hepatitis pathogens could vary from one place to another, therefore, it is not consistent worldwide.

The Special Issue entitled " Emerging Pathogens Causing Acute Hepatitis." aims to present recent research on any aspect of the unusual pathogens causing acute hepatitis of unknown etiology. Some of its focal points include, but are not limited to, the following:

  • acute hepatitis
  • viral causes
  • bacterial causes
  • coinfection of two hepatotropic pathogens
  • diagnosis and outcomes of acute hepatitis

Dr. Ibrahim M. Sayed
Prof. Dr. Sayed F. Abdelwahab
Dr. Ahmed El-Shamy
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Microorganisms is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (7 papers)

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Editorial

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4 pages, 218 KiB  
Editorial
Emerging Pathogens Causing Acute Hepatitis
by Ibrahim M. Sayed, Ahmed El-Shamy and Sayed F. Abdelwahab
Microorganisms 2023, 11(12), 2952; https://doi.org/10.3390/microorganisms11122952 - 10 Dec 2023
Viewed by 924
Abstract
Acute hepatitis is defined as an inflammation or injury in the hepatocytes that continues for a short period of time (less than 6 months) [...] Full article
(This article belongs to the Special Issue Emerging Pathogens Causing Acute Hepatitis)

Research

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12 pages, 823 KiB  
Article
High Incidence of Acute Liver Failure among Patients in Egypt Coinfected with Hepatitis A and Hepatitis E Viruses
by Mohamed A. El-Mokhtar, Amal A. Elkhawaga, Mona Sedky Hussein Ahmed, Ehsan M. W. El-Sabaa, Aliaa A. Mosa, Ahmed Shawkat Abdelmohsen, Abdelmajeed M. Moussa, Eman H. Salama, Sahar Aboulfotuh, Ahmed M. Ashmawy, Ahmed Ismail Seddik, Ibrahim M. Sayed and Haidi Karam-Allah Ramadan
Microorganisms 2023, 11(12), 2898; https://doi.org/10.3390/microorganisms11122898 - 30 Nov 2023
Cited by 1 | Viewed by 1023
Abstract
Hepatitis A virus (HAV) and Hepatitis E virus (HEV) are transmitted through the fecal–oral route. HAV outbreaks and one HEV outbreak have been reported in Egypt. However, the impact of HAV–HEV co-infection is not known. In this study, we assessed HEV markers in [...] Read more.
Hepatitis A virus (HAV) and Hepatitis E virus (HEV) are transmitted through the fecal–oral route. HAV outbreaks and one HEV outbreak have been reported in Egypt. However, the impact of HAV–HEV co-infection is not known. In this study, we assessed HEV markers in acute HAV-infected patients (n = 57) enrolled in Assiut University hospitals. We found that 36.8% of HAV-infected patients were also positive for HEV markers (anti-HEV IgM and HEV RNA), while 63.2% of the patients were HAV mono-infected. Demographic and clinical criteria were comparable in both HAV mono-infected patients and HAV–HEV co-infected patients. Although liver enzymes were not significantly different between the two groups, liver transaminases were higher in the co-infected patients. Six patients developed acute liver failure (ALF); five of them were HAV–HEV-co-infected patients. The relative risk of ALF development was 8.5 times higher in HAV–HEV co-infection compared to mono-infection. Three cases of ALF caused by HAV–HEV co-infection were reported in children (below 18 years) and two cases were reported in adults. All patients developed jaundice, coagulopathy, and encephalopathy; all were living in rural communities. In conclusion: HAV–HEV co-infection can be complicated by ALF. The risk of ALF development in HAV-infected patients is higher when coinfection with HEV is present. Full article
(This article belongs to the Special Issue Emerging Pathogens Causing Acute Hepatitis)
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13 pages, 1648 KiB  
Article
Liver Transaminases in Pediatric Adenovirus Infection—A Five-Year Study in Two Major Reference Centers from Romania
by Oana Săndulescu, Anca Streinu-Cercel, Victor Daniel Miron, Silvia Mirela Covăcescu, Adrian Streinu-Cercel and Mihai Craiu
Microorganisms 2023, 11(2), 302; https://doi.org/10.3390/microorganisms11020302 - 24 Jan 2023
Cited by 3 | Viewed by 2421
Abstract
Human adenovirus causes infections with a very heterogeneous clinical picture, and children are often the most frequently affected group. Interest in adenovirus has increased with the 2022 outbreak of severe acute hepatitis of unknown etiology as human adenovirus was considered as one of [...] Read more.
Human adenovirus causes infections with a very heterogeneous clinical picture, and children are often the most frequently affected group. Interest in adenovirus has increased with the 2022 outbreak of severe acute hepatitis of unknown etiology as human adenovirus was considered as one of the possible etiological agents. We conducted a retrospective study over a 5-year period in two major tertiary hospitals in the Romanian capital with the aim to characterize the clinical picture and the dynamics of liver function tests in children with confirmed adenovirus infection. The study included 1416 children with a median age of 1.1 years (IQR: 0.3, 2.3 years). Digestive symptoms were predominant in 95.2% of children, mainly diarrhea (90.5%) and vomiting (50.5%), and 38.0% had respiratory symptoms. Increased transaminases were identified in 21.5% of patients. Age over 1 year, lethargy, vomiting and dehydration significantly increased the odds of liver cytolysis independent of other risk factors such as chronic conditions or co-infections. Aspartate aminotransferase (AST) was more commonly increased compared to alanine aminotransferase (ALT). Only six children had transaminase increases above 500 U/L, three of which had co-infections with rotavirus, Epstein–Barr virus (EBV), or respiratory syncytial virus (RSV). Liver function tests should be part of routine monitoring for pediatric patients with adenovirus infection. The current study fills a gap in current knowledge related to the frequency and the extent of liver involvement in human adenovirus infection among pediatric patients. Full article
(This article belongs to the Special Issue Emerging Pathogens Causing Acute Hepatitis)
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11 pages, 660 KiB  
Article
The First Report of Coxiella burnetii as a Potential Neglected Pathogen of Acute Hepatitis of Unknown Causes in Egypt
by Mohamed A. El-Mokhtar, Ibrahim M. Sayed, Ayat M. Kamel, Ahmed Atef Mesalam, Elsayed A. Elgohary, Khaled Abo bakr Khalaf, Sara Adel, Azza Abo Elfadl, Walaa A. Khalifa and Haidi Karam-Allah Ramadan
Microorganisms 2022, 10(11), 2168; https://doi.org/10.3390/microorganisms10112168 - 31 Oct 2022
Cited by 6 | Viewed by 1641
Abstract
The World Health Organization (WHO) recently alerted the emergence of new pathogens causing acute hepatitis in children across several countries. This new situation directs us to the screening of neglected pathogens that cause acute hepatitis. Q-fever is a zoonotic disease, caused by Coxiella [...] Read more.
The World Health Organization (WHO) recently alerted the emergence of new pathogens causing acute hepatitis in children across several countries. This new situation directs us to the screening of neglected pathogens that cause acute hepatitis. Q-fever is a zoonotic disease, caused by Coxiella burnetii. Although a high seroprevalence of Coxiella burnetii was recorded in animals present in Egypt, Q-fever is still a neglected disease, and the diagnosis of Q-fever is not routinely performed in Egyptian hospitals. In this study, we performed a retrospective assessment for Coxiella burnetii in cases of hepatitis of unknown causes (HUC) enrolled in Assiut University hospitals, in Egypt. Out of 64 samples of HUC, 54 samples were negative for all hepatitis markers, labeled as acute hepatitis of unknown etiology (AHUE), and 10 samples tested positive for adenovirus and Hepatitis E virus (HEV). Q-fever was detected in 3 out of 54 (5.6%) of AHUE, and one sample was confirmed as coinfection of HEV/Q-fever. Jaundice was the most common clinical symptom developed in the patients. In conclusion, Coxiella burnetii was found to be a potential cause of acute hepatitis in HUC. The diagnosis of Q-fever should be considered in acute hepatitis cases in Egyptian hospitals. Full article
(This article belongs to the Special Issue Emerging Pathogens Causing Acute Hepatitis)
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Review

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17 pages, 1763 KiB  
Review
Rocahepevirus ratti as an Emerging Cause of Acute Hepatitis Worldwide
by Sara Benavent, Silvia Carlos and Gabriel Reina
Microorganisms 2023, 11(12), 2996; https://doi.org/10.3390/microorganisms11122996 - 16 Dec 2023
Cited by 2 | Viewed by 1346
Abstract
The hepatitis E virus (HEV) is a widespread human infection that causes mainly acute infection and can evolve to a chronic manifestation in immunocompromised individuals. In addition to the common strains of hepatitis E virus (HEV-A), known as Paslahepevirus balayani, pathogenic to [...] Read more.
The hepatitis E virus (HEV) is a widespread human infection that causes mainly acute infection and can evolve to a chronic manifestation in immunocompromised individuals. In addition to the common strains of hepatitis E virus (HEV-A), known as Paslahepevirus balayani, pathogenic to humans, a genetically highly divergent rat origin hepevirus (RHEV) can cause hepatitis possessing a potential risk of cross-species infection and zoonotic transmission. Rocahepevirus ratti, formerly known as Orthohepevirus C, is a single-stranded RNA virus, recently reassigned to Rocahepevirus genus in the Hepeviridae family, including genotypes C1 and C2. RHEV primarily infects rats but has been identified as a rodent zoonotic virus capable of infecting humans through the consumption of contaminated food or water, causing both acute and chronic hepatitis cases in both animals and humans. This review compiles data concluding that 60% (295/489) of RHEV infections are found in Asia, being the continent with the highest zoonotic and transmission potential. Asia not only has the most animal cases but also 16 out of 21 human infections worldwide. Europe follows with 26% (128/489) of RHEV infections in animals, resulting in four human cases out of twenty-one globally. Phylogenetic analysis and genomic sequencing will be employed to gather global data, determine epidemiology, and assess geographical distribution. This information will enhance diagnostic accuracy, pathogenesis understanding, and help prevent cross-species transmission, particularly to humans. Full article
(This article belongs to the Special Issue Emerging Pathogens Causing Acute Hepatitis)
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24 pages, 2313 KiB  
Review
Animal Models for Studying Congenital Transmission of Hepatitis E Virus
by Kush Kumar Yadav and Scott P. Kenney
Microorganisms 2023, 11(3), 618; https://doi.org/10.3390/microorganisms11030618 - 28 Feb 2023
Cited by 6 | Viewed by 2562
Abstract
One of the most intriguing issues in the hepatitis E virus (HEV) field is the significant increase in mortality rates of the mother and fetus when infection occurs in the second and third trimesters of gestation. A virus that is normally self-limiting and [...] Read more.
One of the most intriguing issues in the hepatitis E virus (HEV) field is the significant increase in mortality rates of the mother and fetus when infection occurs in the second and third trimesters of gestation. A virus that is normally self-limiting and has a mortality rate of less than one percent in otherwise healthy individuals steeply rises by up to 30% in these pregnant populations. Answering this pivotal question has not been a simple task. HEV, in general, has been a difficult pathogen to understand in the laboratory setting. A historical lack of ability to efficiently propagate the virus in tissue culture models has led to many molecular aspects of the viral lifecycle being understudied. Although great strides have been made in recent years to adapt viruses to cell culture, this field remains behind other viruses that are much easier to replicate efficiently in vitro. Some of the greatest discoveries regarding HEV have come from using animal models for which naturally occurring strains of HEV have been identified, including pigs and chickens, but key limitations have made animal models imperfect for studying all aspects of human HEV infections. In addition to the difficulties working with HEV, pregnancy is a very complicated biological process with an elaborate interplay between many different host systems, including hormones, cardiovascular, kidneys, respiratory, gastrointestinal, epithelial, liver, metabolic, immune, and others. Significant differences between the timing and interplay of these systems are notable between species, and making direct comparisons between animals and humans can be difficult at times. No simple answer exists as to how HEV enhances mortality in pregnant populations. One of the best approaches to studying HEV in pregnancy is likely a combinatorial approach that uses the best combination of emerging in vitro and in vivo systems while accounting for the deficiencies that are present in each model. This review describes many of the current HEV animal model systems and the strengths and weaknesses of each as they apply to HEV pregnancy-associated mortality. We consider factors that are critical to analyzing HEV infection within the host and how, despite no perfect animal model for human pregnancy mortality existing, recent developments in HEV models, both in vitro and in vivo, are advancing our overall understanding of HEV in the pregnant host. Full article
(This article belongs to the Special Issue Emerging Pathogens Causing Acute Hepatitis)
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11 pages, 291 KiB  
Review
Epidemiology and Risk Factors for Acute Viral Hepatitis in Bangladesh: An Overview
by Mohammad Enamul Hoque Kayesh, Michinori Kohara and Kyoko Tsukiyama-Kohara
Microorganisms 2022, 10(11), 2266; https://doi.org/10.3390/microorganisms10112266 - 15 Nov 2022
Cited by 2 | Viewed by 2274
Abstract
Viral infections by hepatotropic viruses can cause both acute and chronic infections in the liver, resulting in morbidity and mortality in humans. Hepatotropic viruses, including hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV), and hepatitis [...] Read more.
Viral infections by hepatotropic viruses can cause both acute and chronic infections in the liver, resulting in morbidity and mortality in humans. Hepatotropic viruses, including hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV), and hepatitis E virus (HEV), are the major pathogens that cause acute and chronic infections in humans. Although all of these viruses can cause acute hepatitis in humans, HAV and HEV are the predominant causative agents in Bangladesh, where the occurrence is sporadic throughout the year. In this review, we provide an overview of the epidemiology of hepatotropic viruses that are responsible for acute hepatitis in Bangladesh. Additionally, we focus on the transmission modes of these viruses and the control and prevention of infections. Full article
(This article belongs to the Special Issue Emerging Pathogens Causing Acute Hepatitis)
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