Clinical characteristics of 1279 patients with hepatitis E in Tianjin

Yang, Hang; Wen, Jun; Zhang, Qian; Chen, Chen; Ma, Haixia; Zhao, Lili; Li, Jia

doi:10.1017/s0950268823001516

Cited by 2 publications

(1 citation statement)

References 42 publications

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“…An estimated 20 million HEV infections occur annually worldwide, resulting in more than 3 million clinical cases [ 2 ]. While most patients with hepatitis E (HE) are asymptomatic and have self-limited disease, a minority can develop liver failure, which is associated with high morbidity and mortality [ 3 , 4 ]. Individuals at increased risk for severe outcomes include pregnant women and individuals with chronic liver disease [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Active surveillance of hepatitis E: a 10-year epidemiological analysis in a city in eastern China

Huang,

Zheng,

Chen

et al. 2024

Emerging Microbes & Infections

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Hepatitis E virus (HEV) is an important cause of acute hepatitis, however, is highly neglected and largely underreported. This study aimed to describe the detailed epidemiology of hepatitis E (HE) through a 10-year surveillance. A community-based active hepatitis surveillance was conducted between November 2007 and October 2017 in 11 townships of Dongtai City in China, involving 355,673 residents. Serum samples were obtained from patients presenting with hepatitis symptoms for more than 3 days. Serum alanine aminotransferase (ALT) levels greater than 2.5 times the upper limit of normal (ULN) were considered acute hepatitis. Samples were subsequently tested for IgG and IgM anti-HEV antibodies, HEV RNA, and hepatitis B surface antigen (HBsAg). The data indicated the incidence of HE fluctuated downward from 2007 to 2017, with an average annual age-standardized incidence of 17.50 per 100,000, exceeding the 10.26 per 100,000 in the National Notifiable Disease Report System (NNDRS). The incidence was notably higher among males (20.95 per 100,000) and individuals aged 50–69 years (37.47 per 100,000). Genotype 4 (HEV-4) was the predominantly circulating genotype during the study period. Furthermore, the study revealed the incidence of hepatitis with HEV and hepatitis B virus (HBV) co-infection was 4.99 per 100,000. The active surveillance system identified a higher incidence of HE compared to NNDRS, with a decreased prevalence over a 10-year period. While efforts are still needed to prevent HE in high-risk populations, including individuals with hepatitis B and the elderly.

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Section: Introductionmentioning

confidence: 99%

Active surveillance of hepatitis E: a 10-year epidemiological analysis in a city in eastern China

Huang,

Zheng,

Chen

et al. 2024

Emerging Microbes & Infections

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Validation of prognostic scores for predicting acute liver failure and in-hospital death in patients with dengue-induced severe hepatitis

Teerasarntipan,

Thanapirom,

Chaiteerakij

et al. 2024

World J Gastroenterol

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BACKGROUND Acute liver failure (ALF) in dengue is rare but fatal. Early identification of patients who are at risk of ALF is the key strategy to improve survival. AIM To validate prognostic scores for predicting ALF and in-hospital mortality in dengue-induced severe hepatitis (DISH). METHODS We retrospectively reviewed 2532 dengue patients over a period of 16 years (2007-2022). Patients with DISH, defined as transaminases > 10 times the normal reference level and DISH with subsequent ALF, were included. Univariate regression analysis was used to identify factors associated with outcomes. Youden’s index in conjunction with receiver operating characteristic (ROC) analysis was used to determine optimal cut-off values for prognostic scores in predicting ALF and in-hospital death. Area under the ROC (AUROC) curve values were compared using paired data nonparametric ROC curve estimation. RESULTS Of 193 DISH patients, 20 developed ALF (0.79%), with a mortality rate of 60.0%. International normalized ratio, bilirubin, albumin, and creatinine were independent predictors associated with ALF and death. Prognostic scores showed excellent performance: Model for end-stage liver disease (MELD) score ≥ 15 predicted ALF (AUROC 0.917, sensitivity 90.0%, specificity 88.4%) and ≥ 18 predicted death (AUROC 0.823, sensitivity 86.9%, specificity 89.1%); easy albumin-bilirubin (ALBI) score ≥ -30 predicted ALF and death (ALF: AUROC 0.835, sensitivity80.0%, specificity 72.2%; death: AUROC 0.808, sensitivity 76.9%, specificity 69.3%); ALBI score ≥ -2 predicted ALF and death (ALF: AUROC 0.806, sensitivity 80.0%, specificity 77.4%; death: AUROC 0.799, sensitivity 76.9%, specificity 74.3%). Platelet-ALBI score also showed good performance in predicting ALF and death (AUROC = 0.786 and 0.699, respectively). MELD and EZ-ALBI scores had similar performance in predicting ALF (Z = 1.688, P = 0.091) and death (Z = 0.322, P = 0.747). CONCLUSION MELD score is the best predictor of ALF and death in DISH patients. EZ-ALBI score, a simpler yet effective score, shows promise as an alternative prognostic tool in dengue patients.

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Clinical characteristics of 1279 patients with hepatitis E in Tianjin

Cited by 2 publications

References 42 publications

Active surveillance of hepatitis E: a 10-year epidemiological analysis in a city in eastern China

Active surveillance of hepatitis E: a 10-year epidemiological analysis in a city in eastern China

Validation of prognostic scores for predicting acute liver failure and in-hospital death in patients with dengue-induced severe hepatitis

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