{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T07:34:10Z","timestamp":1773300850213,"version":"3.50.1"},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,12,1]],"date-time":"2015-12-01T00:00:00Z","timestamp":1448928000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004963","name":"Seventh Framework Programme","doi-asserted-by":"publisher","award":["265994"],"award-info":[{"award-number":["265994"]}],"id":[{"id":"10.13039\/501100004963","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008700","name":"Centre International de Recherche sur le Cancer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000761","name":"Imperial College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000761","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2016,2]]},"abstract":"Summary<\/jats:title>\n \n Background<\/jats:title>\n \n In sub\u2010Saharan Africa, it is unknown whether hepatitis E virus (\n HEV<\/jats:styled-content>\n ) infection is a common precipitating event of acute\u2010on\u2010chronic liver failure (\n ACLF<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n \n To estimate the prevalence of\n HEV<\/jats:styled-content>\n infection in general population and assess whether\n HEV<\/jats:styled-content>\n is a common trigger of\n ACLF<\/jats:styled-content>\n in cirrhotic patients in The Gambia, West Africa.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We first conducted an\n HEV<\/jats:styled-content>\n sero\u2010survey in healthy volunteers. We then tested cirrhotic patients with\n ACLF<\/jats:styled-content>\n (cases) and compensated cirrhosis (controls) for anti\u2010\n HEV<\/jats:styled-content>\n IgG as a marker of exposure to\n HEV<\/jats:styled-content>\n , and anti\u2010\n HEV<\/jats:styled-content>\n IgA and\n HEV RNA<\/jats:styled-content>\n as a marker of recent infection. We also described the characteristics and survival of the\n ACLF<\/jats:styled-content>\n cases and controls.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In the healthy volunteers (\n n<\/jats:italic>\n = 204), 13.7% (95%\n CI<\/jats:styled-content>\n : 9.6\u201319.2) were positive for anti\u2010\n HEV<\/jats:styled-content>\n IgG, and none had positive\n HEV<\/jats:styled-content>\n viraemia. After adjusting for age and sex, the following were associated with positive anti\u2010\n HEV<\/jats:styled-content>\n IgG: being a Christian, a farmer, drinking water from wells, handling pigs and eating pork. In 40 cases (median age: 45 years, 72.5% male) and 71 controls (39 years, 74.6% male), \u226570% were infected with hepatitis B virus. Although hepatitis B flare and sepsis were important precipitating events of\n ACLF<\/jats:styled-content>\n , none had marker of acute\n HEV<\/jats:styled-content>\n .\n ACLF<\/jats:styled-content>\n cases had high (70.0%) 28\u2010day mortality.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Hepatitis E virus infection is endemic in The Gambia, where both faecal\u2010oral route (contaminated water) and zoonotic transmission (pigs\/pork meat) may be important. However, acute\n HEV<\/jats:styled-content>\n was not a common cause of\n acute\u2010on\u2010chronic liver failure<\/jats:styled-content>\n in The Gambia.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/apt.13484","type":"journal-article","created":{"date-parts":[[2015,12,1]],"date-time":"2015-12-01T18:57:00Z","timestamp":1448996220000},"page":"375-384","source":"Crossref","is-referenced-by-count":19,"title":["Hepatitis E virus infection and acute\u2010on\u2010chronic liver failure in West Africa: a case\u2013control study from The Gambia"],"prefix":"10.1111","volume":"43","author":[{"given":"Y.","family":"Shimakawa","sequence":"first","affiliation":[{"name":"MRC Unit The Gambia Banjul The Gambia"},{"name":"Unit\u00e9 d'\u00c9pid\u00e9miologie des Maladies \u00c9mergentes Institut Pasteur Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. 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