Hepatitis E virus superinfection impairs long-term outcome in hospitalized patients with hepatitis B virus-related decompensated liver cirrhosis

Ye, Wenyi; Yu, Xia; Hu, Jianhua; Zhang, Xuan; Yang, Meifang; Sheng, Jifang; Shi, Yu

doi:10.1016/j.aohep.2022.100878

Cited by 10 publications

(5 citation statements)

References 17 publications

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“…HEV infection in a patient with chronic liver disease (CLD) previously infected with another virus (Hepatitis B), is considered HEV superinfection. A study has shown that HEV superinfection accelerated disease progression and increased long-term mortality in patients with hepatitis B liver cirrhosis, especially in patients with end-stage liver cirrhosis [ 72 ].…”

Section: Clinical Presentationmentioning

confidence: 99%

Hepatitis E Virus (HEV) Synopsis: General Aspects and Focus on Bangladesh

Aziz

Øverbø

Julin

et al. 2022

Viruses

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HEV is the most common cause of acute hepatitis globally. This review summarizes the latest knowledge on the epidemiology, clinical characteristics, testing, and treatment of HEV infection. We also focused on Bangladesh to highlight the distinct challenges and the possible remedies. In low-income settings, the virus is mainly transmitted between people by fecal contamination of drinking water causing large outbreaks, and sporadic cases. The disease is usually mild and self-limiting acute hepatitis. Still, pregnant women and their offspring in low-income countries are at particular risk for severe disease, with up to 20% maternal mortality. Despite the high burden of the disease, HEV remains a relatively neglected virus, with detection hampered by costly tests and a lack of suitable treatments. Molecular PCR diagnostics, together with ELISA antibody tests, remain the preferred methods for diagnosis of HEV; however, rapid bedside diagnostics are available and could offer a practical alternative, especially in low-income countries. One vaccine (HEV 239) is only available in China and Pakistan, as efficacy against the other genotypes remains uncertain. The effectiveness trial conducted in Bangladesh might lead the way in gathering more efficacy data and could, together with improved surveillance and raised awareness, dramatically reduce the global burden of HEV.

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Section: Clinical Presentationmentioning

confidence: 99%

Hepatitis E Virus (HEV) Synopsis: General Aspects and Focus on Bangladesh

Aziz

Øverbø

Julin

et al. 2022

Viruses

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“…More effective anti-HEV drugs need to be developed for severe HEV infection, particularly, in pregnant females (24). HEV-infected patients with cirrhosis with or without HBV infection may develop ACLF, which is associated with a high mortality rate (~70%) (25)(26)(27).…”

Section: Discussionmentioning

confidence: 99%

Severe hepatitis E virus genotype 3b in a patient with alcohol‑associated liver disease: A case report

Kanda,

Arima,

Sasaki‑Tanaka

et al. 2024

Med Int

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Hepatitis E virus (HEV) infection occasionally causes acute-on-chronic liver failure in patients with alcohol-associated cirrhosis. These reports have been published mainly from highly HEV genotype 1-endemic countries. The present study describes the case of a patient with severe HEV genotype 3b infection and alcohol-associated liver disease. A male patient in his 70s who consumed alcohol, and who had begun consuming alcohol at the age of 12, had high levels of alanine aminotransferase (ALT) and total bilirubin. The peak levels of ALT and total bilirubin were 1,067 IU/l and 26.3 mg/dl, respectively. A computed tomography scan revealed an atrophic liver. Upon admission, both anti-HEV immunoglobulin A and HEV RNA were positive, and his HEV was genotype 3b. He also had chronic kidney disease, as his estimated glomerular filtration rate was <45 ml/min/1.73 m 2 , and ribavirin could not be used. The abnormal levels of the liver function parameters of the patient gradually improved due to conservative treatment, and he was discharged on day 43. On the whole, the present study demonstrates that careful attention should be paid to patients with viral hepatitis, including hepatitis E, when alcohol-associated liver disease is present. Novel anti-HEV drugs need to be developed for severe HEV infections with chronic kidney disease.

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“…This study also found that patients with hepatitis E who progressed to liver failure had lower platelet counts and smaller spleen sizes, which may also be due to these patients having liver cirrhosis [ 23 ]. Zhao et al [ 24 ] investigated the specific role of HEV superinfection in the long-term outcome of hepatitis B virus (HBV) patients with liver cirrhosis and found that co-infection was associated with higher mortality. Many studies have reported that HEV infection could accelerate disease progression in patients with underlying chronic liver disease and increase morbidity and mortality in these patients [ 25 – 28 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of 1279 patients with hepatitis E in Tianjin

Yang,

Wen,

Zhang

et al. 2023

Epidemiol. Infect.

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Hepatitis E virus infection is a major cause of acute hepatitis, typically self-limiting but occasionally leading to liver failure. Understanding disease progression factors could inform prevention strategies. This study aimed to analyse the characteristics of a large cohort of hospitalised hepatitis E patients in Tianjin, China, and explore factors influencing their progression to liver failure. A total of 1279 hospitalised patients with hepatitis E were included in this cross-sectional study in Tianjin, China. Student's t-test and the Mann–Whitney U-test were used for comparisons. Multiple logistic regression analysis was used to explore the association. Among these 1279 patients, 107 (8.4%) developed liver failure. Patients with diabetes mellitus (DM) (95% confidence interval [CI] 1.150–2.887, p = 0.011), liver cirrhosis (95% [CI] 2.229–7.224, p < 0.001), and hepatitis B (95% [CI] 1.159–4.512, p = 0.017) were more likely to progress to liver failure. Hepatitis E patients with comorbid DM, liver cirrhosis, or hepatitis B virus co-infection have higher risks of developing liver failure. Hepatitis E vaccination may be recommended for these vulnerable patients to curb disease severity.

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Hepatitis E virus superinfection impairs long-term outcome in hospitalized patients with hepatitis B virus-related decompensated liver cirrhosis

Cited by 10 publications

References 17 publications

Hepatitis E Virus (HEV) Synopsis: General Aspects and Focus on Bangladesh

Hepatitis E Virus (HEV) Synopsis: General Aspects and Focus on Bangladesh

Severe hepatitis E virus genotype 3b in a patient with alcohol‑associated liver disease: A case report

Clinical characteristics of 1279 patients with hepatitis E in Tianjin

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