Analysis of epidemiological and clinical features of 621 patients with acute hepatitis E / 中华传染病杂志

ABSTRACT

Objective To investigate the epidemiological and clinical features of acute hepatitis E (AHE).Methods All the data of AHE patients from April 2005 to October 2011 were collected and their epidemiological features were retrospectively analyzed.Patients were divided into two groupspatients with single hepatitis E virus (HEV ) infection and patients with HEV/hepatitis B virus (HBV ) coinfection,to compare the biochemical parameters and outcomes and to find out the risk factors for AHE related liver failure.Kruskal-Wallis test,Chi square test,and Logistical regression analysis were used for statistical analysis.Results A total of 621 cases were included in the present study and most patients were elderly male and happened from February to May every year.The incidence of AHE related liver failure and mortality was 18.68% and 1 .93%,respectively.Compared to the single HEV group (n=331 ),the HEV/HBV group (n = 280 )had a longer hospital stay (46 d vs 40 d,Z = - 4.591 ,P < 0.01 ),a significantly lower prothrombin activity (55 .5 % vs 78.7%,Z =-7.998,P <0.01 )and a significantly higher incidence of AHE related liver failure (30.7% vs 9.1 %,χ2 =46.229,P <0.01 ).In single HEV related liver failure group (n=30),the percentages of early-stage,interim-stage and end-stage live failure were 53.33%,23.33% and 23.33%,respectively.While in the HEV/HBV related liver failure group (n=86),the corresponding numbers were 34.88%,31 .40% and 33.72%,respectively.The differences were not statistically significant (χ2 = 3.176,P = 0.204 ).Additionally,the clinical outcome between these two groups was also comparable (83.33% vs 91 .86%,χ2 =0.945 ,P = 0.331 ).The Logistic analysis showed that age over 50 years (OR=2.080,P =0.002)and coinfection with HBV (OR=5 .632, P <0.01)were risk factors for AHE related liver failure.Conclusions AHE is seasonal and mainly occurs in elderly male.Advanced age and HBV coinfection may be risk factors of severe AHE.