Respiratory Department of Chengdu Sixth People's Hospital, Sichuan, China.
Infectious Diseases Department of People's Hospital of Fengjie, Chongqing, China.
J Med Virol. 2019 Mar;91(3):437-443. doi: 10.1002/jmv.25335. Epub 2018 Nov 13.
To investigate the serum anti-hepatitis E virus (HEV) antibody positive rate in patients with different types of chronic hepatitis (CH) or cirrhosis.
A total of 1751 hospitalized patients were chart reviewed, who were diagnosed with mono-CH or cirrhosis between 2011 and 2016.
The total anti-HEV-IgG positive rate was 1.33% (13/981) in CH patients, which was significantly lower than that (6.49%; 50/770) in cirrhosis patients (odds ratio [OR], 4.78 [2.51-9.10]; P = 0.00). The comparison of positive rate of anti-HEV-IgG between the same etiology CH and cirrhosis groups was as follows: chronic hepatitis B 1.27% (10/790) versus hepatitis B virus (HBV)-related cirrhosis 4.21% (22/522) (OR, 3.04 [1.36-6.77]; P = 0.00); chronic alcoholic hepatitis 1.41% (1/71) versus alcoholic cirrhosis 9.40% (11/117) (OR, 8.00 [1.00-64.25]; P = 0.03); chronic autoimmune hepatitis 1.69% (1/59) versus autoimmune cirrhosis 13.33% (12/90) (OR, 13.11 [1.49-115.27]; P = 0.01); the differences above were statistically significant. And chronic hepatitis C 3.23% (1/31) versus hepatitis C virus-related cirrhosis 10.81% (4/37) (OR, 4.40 [0.45-43.53]; P > 0.05); chronic NASH 0.00% (0/30) versus NASH-related cirrhosis 25.00% (1/4) (P > 0.05), the differences were not statistically significant. Anti-HEV-IgG positive rates were also compared among different types of CH groups and no significant difference was found. Likewise, anti-HEV-IgG positive rate was compared among different types of cirrhosis groups, showing that the positive rates of both alcoholic cirrhosis (9.40%) and autoimmune cirrhosis (13.33%) were significantly higher than that of HBV-related cirrhosis (4.21%) (P < 0.05).
We observed that the cirrhosis patients had a significantly higher anti-HEV-IgG positive rate comparing with the CH patients, especially in those with HBV-related, alcohol-related, and autoimmune-related cirrhosis (after adjusted for age). Additionally, it seems that the conditions of alcoholic cirrhosis and autoimmune cirrhosis are more susceptible to HEV infection due to the significantly higher positive anti-HEV-IgG rate in these patients.
研究不同类型慢性肝炎（CH）或肝硬化患者血清抗戊型肝炎病毒（HEV）抗体的阳性率。
对 2011 年至 2016 年间诊断为单 CH 或肝硬化的 1751 例住院患者进行图表回顾。
CH 患者的总抗-HEV-IgG 阳性率为 1.33%（13/981），明显低于肝硬化患者的 6.49%（50/770）（比值比[OR]，4.78[2.51-9.10]；P=0.00）。同病因 CH 和肝硬化组抗-HEV-IgG 阳性率的比较如下：慢性乙型肝炎 1.27%（10/790）与乙型肝炎病毒（HBV）相关性肝硬化 4.21%（22/522）（OR，3.04[1.36-6.77]；P=0.00）；慢性酒精性肝炎 1.41%（1/71）与酒精性肝硬化 9.40%（11/117）（OR，8.00[1.00-64.25]；P=0.03）；慢性自身免疫性肝炎 1.69%（1/59）与自身免疫性肝硬化 13.33%（12/90）（OR，13.11[1.49-115.27]；P=0.01），差异均有统计学意义。慢性丙型肝炎 3.23%（1/31）与丙型肝炎病毒相关性肝硬化 10.81%（4/37）（OR，4.40[0.45-43.53]；P>0.05）；慢性非酒精性脂肪性肝炎 0.00%（0/30）与非酒精性脂肪性肝炎相关性肝硬化 25.00%（1/4）（P>0.05），差异无统计学意义。不同类型 CH 组间抗-HEV-IgG 阳性率也进行了比较，差异无统计学意义。同样，肝硬化各类型组间抗-HEV-IgG 阳性率比较显示，酒精性肝硬化（9.40%）和自身免疫性肝硬化（13.33%）的阳性率明显高于 HBV 相关性肝硬化（4.21%）（P<0.05）。
我们观察到，与 CH 患者相比，肝硬化患者的抗-HEV-IgG 阳性率明显更高，尤其是 HBV 相关、酒精相关和自身免疫相关的肝硬化（经年龄调整后）。此外，由于这些患者抗-HEV-IgG 阳性率显著升高，似乎酒精性肝硬化和自身免疫性肝硬化的病情更容易受到 HEV 感染。
