Incidence, predictors and prognosis of genotype 4 hepatitis E related liver failure: A tertiary nested case‐control study

Wang, Yijin; Li, Hongyang; Liu, Shuhong; Yang, Changshuang; Jiang, Yong; Wang, Shan; Liu, Aixia; Peppelenbosch, Maikel P.; Kamar, Nassim; Zhao, Jingmin

doi:10.1111/liv.14221

Cited by 18 publications

(12 citation statements)

References 41 publications

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“…Acute hepatitis E (AHE) is caused by hepatitis E virus (HEV) infection, which is endemic in many developing countries because of poor sanitation 1 . The virus is predominantly transmitted by the faecal‐oral route 2 .…”

Section: Introductionmentioning

confidence: 99%

Altered faecal microbiota on the expression of Th cells responses in the exacerbation of patients with hepatitis E infection

Huang

Ling

et al. 2020

Journal of Viral Hepatitis

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Fulminant hepatitis E may lead to acute liver failure (ALF). Perturbations of intestinal microbiota are related to severe liver disease. To study the correlations between faecal microbiota and the occurrence and exacerbation of hepatitis E virus (HEV) infection, we characterized 24 faecal samples from 12 patients with acute hepatitis E (AHE) and 12 patients with HEV-ALF using high-throughput sequencing. We found both the alpha and beta diversity indices showed no significant differences between the AHE and HEV-ALF groups. Several predominant taxa were significantly different between the AHE and HEV-ALF groups. Most notably, the HEV-ALF group had increased levels of Gammaproteobacteria, Proteobacteria, Xanthomonadceae and Stenotrophomonas, but reduced levels of Firmicutes, Streptococcus, Subdoligranulum and Lactobacillus, compared with the AHE group. The levels of Lactobacillaceae and Gammaproteobacteria could be used to distinguish patients with HEV-ALF from those with AHE. In addition, the level of Th lymphocytes was significantly lower in the HEV-ALF group than in the AHE group. The relative abundances of Lactobacillaceae and Gammaproteobacteria were positively correlated with Th lymphocytes, serum international normalized ratio (INR) and hepatic encephalopathy severity. Moreover, surviving patients had higher levels of Lactobacillus mucosae than deceased patients. Our study demonstrated that the presence of altered faecal microbiota is associated with exacerbation of HEV infection; this finding may be useful for exploring the interactions among faecal microbiota, immune responses, mechanisms of infection and progression in patients with HEV, as well as for the development of novel diagnostic and therapeutic strategies.

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Section: Introductionmentioning

confidence: 99%

Altered faecal microbiota on the expression of Th cells responses in the exacerbation of patients with hepatitis E infection

Huang

Ling

et al. 2020

Journal of Viral Hepatitis

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“…Additionally, LDH can be an accurate symbol of hepatic injury (38,39). Further, LDH levels are associated with the dysfunction of various organs (40,41), which can lead to major postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Changes in serum lactate dehydrogenase levels as markers of pathological response and prognosis in colorectal liver metastases patients receiving neoadjuvant chemotherapy followed by resection

Chen¹,

Chen²,

Yao³

et al. 2021

Ann Palliat Med

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Background: This study sought to evaluate the effects of pre-neoadjuvant chemotherapy lactate dehydrogenase (pre-NAC LDH) levels, preoperative LDH levels, and changes in LDH levels on the pathological response and outcomes of colorectal liver metastases (CRLM) patients treated with liver resection after NAC.Methods: This study included 152 colorectal CRLM patients, who underwent NAC followed by liver resection. Patients were excluded if they were diagnosed with other malignancies or lacked follow-up and clinical data. Demographic and clinicopathological data were collected from hospital records. Pathological response and postoperative complications were measured according to the tumor regression grade (TRG) and Clavien-Dindo classification system, respectively. The optimal cutoff values were determined by the receiver operating characteristic curve and the X-tile analysis. Changes in LDH levels were graded as 0, 1, and 2. A logistic regression analysis was conducted to identify the independent predictors of pathological response and postoperative major complications. Univariate and multivariate Cox regression analyses were used to identify the independent risk factors of progression-free survival (PFS) and overall survival (OS). Results: The multivariate analysis indicated that a grade 2 LDH level change was a risk factor of an unfavorable histological response [odds ratio (OR) 0.249, 95% confidence interval (CI): 0.066-0.942; P=0.041] and major postoperative complications (OR 2.523, 95% CI: 1.179-10.530; P=0.024), which were independent of other clinical covariates. A pre-NAC LDH level ≥145 IU/L [hazards ratio (HR) 0.584, 95% CI: 0.359-0.950; P=0.030], a grade 1 LDH level change (HR 0.584, 95% CI: 0.359-0.950; P=0.030) and a grade 2 LDH level change (HR 0.447, 95% CI: 0.231-0.864; P=0.017) were independent prognostic predictors of PFS. A preoperative a LDH level ≥231 IU/L (HR 0.405, 95% CI: 0.192-0.852; P=0.017) and a grade 2 LDH level change (HR 0.362, 95% CI: 0.157-0.834; P=0.017) were independent prognostic factors of OS, which were independent of other clinical covariates.Conclusions: LDH levels and changes in LDH levels are potentially useful biomarkers for predicting the pathological response and prognosis of CRLM patients receiving NAC followed by liver resection.

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“…Although it remains unknown whether mixed infection of HEV contributes to severe hepatitis, 25,26 GT4c was likely to have contributed to the development of acute liver failure in case 1. In addition, other GT4 subtypes, including GT4d, may have a potential to present severe hepatitis 27 …”

Section: Discussionmentioning

confidence: 99%

Clinical and virologic features of hepatitis E virus infection at a university hospital in Japan between 2000 and 2019

Sato

Watanabe

Miura

et al. 2020

Journal of Medical Virology

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The clinical and virologic features of hepatitis E virus (HEV) infection seem to vary among regions even in developed countries. However, we have little information on the diversity of HEV infection. Here, we investigated the characteristics of 26 patients in our hospital located in Tochigi prefecture, 90 km north of Tokyo, between 2000 and 2019. The reported number of patients with acute hepatitis E is increasing in Japan because measurement of IgA‐class anti‐HEV antibody was commercially available from 2011. In contrast, the numbers at our hospital were 1.5/y and 1.0/y in 2000 to 2011 and 2012 to 2019, respectively. This is attributed to the fact that we have been investigating HEV as a cause of unknown hepatitis before 2011. Among isolated HEV subgenotypes, including 3a, 3b, 4b, 4c, and 4d, all three patients with subgenotype 4c infection presented acute liver failure. Four HEV strains shared more than or equal to 99% identity within the 412‐nucleotide partial sequence, in which the time and place of HEV infection varied, except for one intrafamilial infection. In addition, some strains were similar to HEV strains isolated far from Tochigi prefecture. In conclusion, the number of patients with acute hepatitis E was not increasing at Jichi Medical University Hospital and some strains were found to circulate in Japan.

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Incidence, predictors and prognosis of genotype 4 hepatitis E related liver failure: A tertiary nested case‐control study

Cited by 18 publications

References 41 publications

Altered faecal microbiota on the expression of Th cells responses in the exacerbation of patients with hepatitis E infection

Altered faecal microbiota on the expression of Th cells responses in the exacerbation of patients with hepatitis E infection

Changes in serum lactate dehydrogenase levels as markers of pathological response and prognosis in colorectal liver metastases patients receiving neoadjuvant chemotherapy followed by resection

Clinical and virologic features of hepatitis E virus infection at a university hospital in Japan between 2000 and 2019

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