Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN, USA.
J Viral Hepat. 2021 Apr;28(4):672-681. doi: 10.1111/jvh.13458. Epub 2021 Jan 5.
Hepatitis E is considered rare in the United States (US) despite its widespread occurrence in Asian and African countries. The objective of this study was to describe the characteristics of hepatitis E-related pregnancies and acute-on-chronic liver failure and analyse trends for hepatitis E diagnosis among hospitalized patients in the US. We examined data from the 2010-2017 National Inpatient Sample from Healthcare Cost and Utilization Project to determine mortality, morbidity, pregnancy diagnoses, chronic liver disease diagnoses, and other conditions during hospitalization. Data were extracted for hospitalizations with hepatitis E as defined by ICD-9 codes 070.43 and 070.53 and ICD-10 code B17.2. Of 208,462,242 hospitalizations from 2010-2015, we identified 960 hepatitis E hospitalizations. The hospitalization rate of hepatitis E was 3.7 per 10 million in 2010 and 6.4 per 10 million in 2015 (β = 0.60, p = 0.011). From 2015 to 2017, the hospitalization appeared to increase with slope (β) of 0.50. Among those hospitalizations, 34 (4%) died and 85 (9%) had acute-on-chronic liver failure. Ninety-five (10%) had a diagnosis of pregnancy, there were no reports of maternal or foetus/neonate deaths, but there was a high proportion of adverse events for both during hospitalization. Having a chronic liver disease was associated with hepatic coma diagnosis (OR = 10.94, p = 0.002). Although the hospitalization rate of hepatitis E in the US is low, it appears to be increasing over time. Further studies are necessary in order to conclude a causal association of hepatitis E with adverse events and mortalities in pregnancy and chronic liver disease in the US.
戊型肝炎在美国被认为较为罕见，尽管其在亚洲和非洲国家广泛流行。本研究旨在描述与戊型肝炎相关的妊娠和慢加急性肝衰竭的特征，并分析美国住院患者中戊型肝炎诊断的趋势。我们检查了医疗保健成本和利用项目 2010-2017 年国家住院患者样本中的数据，以确定死亡率、发病率、妊娠诊断、慢性肝病诊断和住院期间的其他情况。数据是根据 ICD-9 代码 070.43 和 070.53 和 ICD-10 代码 B17.2 从 2010-2015 年的住院患者中提取的，这些患者被诊断为戊型肝炎。在 2010-2015 年的 208462242 例住院患者中，我们确定了 960 例戊型肝炎住院患者。2010 年戊型肝炎的住院率为每 100 万人 3.7 例，2015 年为每 100 万人 6.4 例（β=0.60，p=0.011）。从 2015 年到 2017 年，住院率呈上升趋势，斜率（β）为 0.50。在这些住院患者中，34 人（4%）死亡，85 人（9%）患有慢加急性肝衰竭。95 人（10%）被诊断为妊娠，没有孕产妇或胎儿/新生儿死亡的报告，但住院期间两者的不良事件比例都很高。患有慢性肝病与肝性脑病诊断相关（OR=10.94，p=0.002）。尽管美国戊型肝炎的住院率较低，但它似乎随着时间的推移而增加。为了得出美国妊娠和慢性肝病中戊型肝炎与不良事件和死亡率之间因果关系的结论，还需要进一步研究。
