An Wen, Li Mengqi, Luo Jing, Yu Zhe, Wei Hongshan
Department of Gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Department of Gastroenterology, Peking University Ditan Teaching Hospital, Beijing, China.
J Viral Hepat. 2025 Apr;32(4):e14018. doi: 10.1111/jvh.14018. Epub 2024 Oct 8.
Acute hepatitis E virus infection is a serious global health problem, which a significant cause of morbidity and mortality. The aim of the present study was to characterise the clinical features and therapeutic response of patients with acute HEV infection and identify risk factors for poor prognosis. In a retrospective study from 01 January 2014 to 01 Januray 2022, we collected baseline data from all patients eligible for acute hepatitis E virus (HEV) infection and followed up with all patients via interviews and medical records. We explored the clinical feature of Chinese patients with acute HEV infection. The follow-up data of patients were used to identify risk factors for poor prognosis. In total, 628 acute hepatitis E (AHE) patients fulfilled the inclusion criteria and did not meet the exclusion criteria. Among them, 452 were males and 176 were females (M:F = 2.57:1). The median age at diagnosis was 57.0 years (interquartile range: 46-64 years). The median baseline serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBIL) were elevated in this cohort (642.3 U/L, 216.2 U/L, 104.1 μmol/L, respectively). The median hospitalisation duration was 16 days. Compared with patients without other liver diseases, patients with liver cirrhosis show lower baseline ALT and AST level, poorer coagulation indices and higher MELD scores. According to multivariate analysis, liver cirrhosis, high MELD score, low albumin concentration was found to be independent predictors of poor prognosis in patients with AHE. Our study used a lager sample size to validate that some demographic and serological features were quite different between patients with/without CLDs. Liver cirrhosis was a significant independent predictor of poor prognosis in acute HEV hepatitis.
戊型肝炎病毒急性感染是一个严重的全球健康问题，是发病和死亡的一个重要原因。本研究的目的是描述急性戊型肝炎病毒感染患者的临床特征和治疗反应，并确定预后不良的危险因素。在一项从2014年1月1日至2022年1月1日的回顾性研究中，我们收集了所有符合急性戊型肝炎病毒（HEV）感染条件的患者的基线数据，并通过访谈和病历对所有患者进行了随访。我们探讨了中国急性戊型肝炎病毒感染患者的临床特征。患者的随访数据用于确定预后不良的危险因素。共有628例急性戊型肝炎（AHE）患者符合纳入标准且未符合排除标准。其中，男性452例，女性176例（男：女 = 2.57:1）。诊断时的中位年龄为57.0岁（四分位间距：46 - 64岁）。该队列中丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）和总胆红素（TBIL）的基线血清水平中位数均升高（分别为642.3 U/L、216.2 U/L、104.1 μmol/L）。中位住院时间为16天。与无其他肝病的患者相比，肝硬化患者的基线ALT和AST水平较低，凝血指标较差，终末期肝病模型（MELD）评分较高。根据多因素分析，肝硬化、高MELD评分、低白蛋白浓度被发现是急性戊型肝炎患者预后不良的独立预测因素。我们的研究使用了较大的样本量来验证有/无慢性肝病患者之间的一些人口统计学和血清学特征存在相当大的差异。肝硬化是急性戊型肝炎预后不良的一个重要独立预测因素。
