SPREAD OF HEV INFECTION IN BULGARIA.

Objectives: In the last few years an increasing frequency of diagnosed cases of HEV infections has been reported from various European countries. In recent years sporadic cases of HEV infections have emerged also in Bulgaria. METHOD‟s: In this retrospective study, 21 patients with acute viral hepatitis type E were included. To describe the clinical and demographic characteristic, we used information from cases recorded at the Clinic of Infectious Diseases, Military Medical Academy - Sofia, from January 2008 to December 2012. The diagnosis of HEV infection was confirmed by the finding of anti-HEV antibodies of class IgG and IgM (ELISA) in acute phase, and by disappearing of IgM anti-HEV in the convalescent period. Statistical analysis was performed using the chi-square test. RESULT‟s: Acute viral hepatitis E composes 5.8% of all acute viral hepatitis treated in Clinic of infectious diseases, MMA - Sofia. The mean age of the patients was 52.4 and 57.1% were males. The most frequent clinical signs were mild to moderate upper gastric symptoms (65%) and liver enlargement (91%). One of the patients was with coinfection HEV+HBV with signs of threatening acute hepatic failure. Another patient was a probable case of chronic HEV infection. The cholestasis enzymes (ALP and GGT) were elevated by most of the patients, but without clinical evidence of cholestasis. CONCLUSION‟S: Acute hepatitis E in Bulgaria emerges as an autochthonous infection with a low incidence rate. Most of the patients were with mild clinical form of acute viral hepatitis E. Patients with severe form have a history of chronic liver disease or co-infections. The question of probable chronic form of HEV infection was discussed. [ABSTRACT FROM AUTHOR]