Abstract
Symptomatic hepatitis E virus (HEV) infection is sporadic, and usually occurs in a limited number of infected patients, which hinders the investigation of risk factors for clinical outcomes in patients with acute HEV infection. A retrospective cohort study enrolling 1913 patients with symptomatic acute hepatitis E in Beijing 302 Hospital from January 1, 2001 to December 31, 2018 was conducted. The baseline characteristics, clinical features and laboratory data of these HEV infection cases were analyzed. Albumin (ALB), platelet (PLT), alanine aminotransferase (ALT), total bilirubin (T-BiL), international normalized ratio (INR) and serum creatinine (SCR) levels, along with the model for end-stage liver disease (MELD) score, hospitalization days, co-morbidity number and mortality were taken as major parameters for comparing the clinical manifestations in our study. We found that not all pre-existing chronic liver diseases exacerbate clinical manifestations of acute hepatitis E. Alcoholic hepatitis, fatty liver hepatitis, hepatic cyst, drug-induced hepatitis and hepatocellular carcinoma were not significantly associated with mortality of HEV patients. Among all of the comorbidities, end-stage liver diseases (ESLDs, including ascites, cirrhosis, hepatic coma and hepatorenal syndrome), respiratory tract infection and chronic kidney diseases (CKDs, including renal insufficiency and renal failure) were found to remarkably increase the mortality of patients with symptomatic HEV infection. Furthermore, the severity evaluation indexes (SEI), such as MELD score, duration of hospital stay, and co-morbidity number in HEV patients with underlying comorbidities were much worse than that of their counterparts without relevant comorbidities.
Highlights
As the etiological cause of adverse liver events, infection of hepatitis E virus (HEV) has become an important public health problem worldwide, especially in some developing countries with poor sanitary conditions
The anti-HEV IgM and IgG antibodies were determined using commercial HEV ELISA Kit (Modern Gaoda, Beijing, China; Registration Certificate Number: CFDA-20133401154, CFDA-20133401615), and the sensitivity and specificity of the anti-HEV IgM kit are 98.5% and 94.8% separately according to the manufacturer’s instructions, the same assay was used throughout the study. 162 cases were excluded by the initial screening due to
A total of 1913 patients with acute hepatitis E were enrolled in this retrospective study (Figure 1).The study was approved by the ethics committee of the Beijing 302 Hospital/The Fifth Medical Center of PLA General Hospital, and the approval number is 2019020D
Summary
As the etiological cause of adverse liver events, infection of hepatitis E virus (HEV) has become an important public health problem worldwide, especially in some developing countries with poor sanitary conditions. Current knowledge on the effects of underlying comorbidities to symptomatic acute HEV patients is scarce, and most related clinical studies have been conducted with a limited number of cases (Kumar Acharya et al, 2007; Radha Krishna et al, 2009; Zhang et al, 2010; Zhang et al, 2011; Cheng et al, 2013; Blasco-Perrin et al, 2015; Chen et al, 2016; Zhang et al, 2017; Lai et al, 2018), which hinders the convincing analysis of underlying comorbidities as independent risk factors for symptomatic acute HEV infection. Some other studies showed that chronic hepatitis C (Samala et al, 2016) and alcoholic hepatitis (Haim-Boukobza et al, 2015) are not associated with the poorer manifestation of patients with acute hepatitis E
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
