Acute hepatitis E virus superinfection increases mortality in patients with cirrhosisopen access
- Choi, Jung Woo; Son, Ho Jin; Lee, Sang Soo; Jeon, Hankyu; Cho, Jin-Kyu; Kim, Hee Jin; Cha, Ra Ri; Lee, Jae Min; Kim, Hyun Jin; Jung, Woon Tae; Lee, Ok-Jae
- Issue Date
- Hepatitis E virus; Chronic liver disease; Cirrhosis; Acute-on-chronic liver failure; Mortality
- BMC INFECTIOUS DISEASES, v.22, no.1
- Journal Title
- BMC INFECTIOUS DISEASES
- Background Although acute hepatitis E is not fatal in healthy individuals, it is unclear whether hepatitis E superinfection increases the mortality in patients with pre-existing liver disease. Thus, we investigated the prognosis of patients with acute hepatitis E according to their cirrhosis diagnosis, and the prognosis according to the development of acute-on-chronic liver failure (ACLF) in patients with cirrhosis and chronic liver disease (CLD). Methods This study included 74 consecutive patients who were diagnosed with acute viral hepatitis E between January 2007 and December 2019. Of them, 39 patients without CLD, 13 patients with non-cirrhotic CLD, and 22 patients with cirrhotic CLD were analyzed. Results Among the 74 patients with HEV infection, 7 (9.5%) died within 180 days: 5 with underlying cirrhosis (71.4%) and 2 without cirrhosis (28.6%). The 180-day mortality was significant higher for patients with cirrhosis than for patients without cirrhosis (22.7% vs. 3.8%, P = 0.013). The age- and sex-adjusted proportional-hazard model revealed an approximately eightfold increase in the 180-day mortality risk in patients with cirrhosis compared to patients without cirrhosis. In addition, development of hepatitis E virus-related ACLF due to acute liver function deterioration in patients with pre-existing CLD or cirrhosis worsened the 180-day mortality rate. Conclusions Our findings suggest that the acute hepatitis E mortality rate was low in healthy individuals but higher in patients with cirrhosis, and especially high in those with ACLF.
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- College of Medicine > Department of Medicine > Journal Articles
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