{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:26:38Z","timestamp":1790627198517,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,9,7]],"date-time":"2017-09-07T00:00:00Z","timestamp":1504742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Autochthonous hepatitis E is increasingly recognized as zoonotic infection in western countries. Serological assays have varying sensitivity and specificity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We implemented molecular testing to identify and characterize acute hepatitis E acquired in Switzerland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ninety\u2010three cases of mostly symptomatic acute hepatitis E acquired in Switzerland were documented by\n                      <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>\n                      between November 2011 and December 2016. Median\n                      <jats:styled-content style=\"fixed-case\">HEV RNA<\/jats:styled-content>\n                      was 7.5\u00a0x\u00a010\n                      <jats:sup>4<\/jats:sup>\n                      <jats:styled-content style=\"fixed-case\">IU<\/jats:styled-content>\n                      \/mL (range, 5.3 to 4.7\u00a0x\u00a010\n                      <jats:sup>7<\/jats:sup>\n                      <jats:styled-content style=\"fixed-case\">IU<\/jats:styled-content>\n                      \/mL).\n                      <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>\n                      genotyping was successful in 78 patients, revealing genotype 3 in 75 and genotype 4 in three patients. Phylogenetic analyses revealed a few limited geographical and temporal clusters. Of the 91 patients with available anti\u2010\n                      <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>\n                      IgM serology, four were negative; three of these were also IgG\u2010negative, likely as a result of immunosuppression, and one was IgG\u2010positive, a constellation compatible with\n                      <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>\n                      reinfection. Median age of the patients was 58\u00a0years (range, 20\u201080\u00a0years); 71 (76.3%) were men and 49 of these (69.0%) were \u2265\u00a050\u00a0years old. The clinical course was particularly severe in patients with underlying chronic liver disease, with fatal outcome in two patients. Six patients (6.5%) presented with neuralgic amyotrophy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Nucleic acid\u2010based diagnosis reveals\n                      <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>\n                      as a relevant cause of acute hepatitis in Switzerland. Middle\u2010aged and elderly men constitute the majority of symptomatic patients. Testing for\n                      <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>\n                      should be included early in the diagnostic workup of acute hepatitis and of neuralgic amyotrophy, a typical extrahepatic manifestation of\n                      <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>\n                      genotype 3 infection.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.13557","type":"journal-article","created":{"date-parts":[[2017,8,23]],"date-time":"2017-08-23T09:46:42Z","timestamp":1503481602000},"page":"619-626","source":"Crossref","is-referenced-by-count":33,"title":["Hepatitis E virus as a cause of acute hepatitis acquired in Switzerland"],"prefix":"10.1111","volume":"38","author":[{"given":"Montserrat","family":"Fraga","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology University Hospital Lausanne  Lausanne 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