Clinical features of patients with superinfection of HEV and HBV related acute on chronic liver failure / 重庆医学

ABSTRACT

Objective To investigate the clinical features of patients with superinfection of HEV and HBV related acute on chro-nic liver failure(ACLF) .Methods Clinical data of 35 patients diagnosed with superinfection of HEV and HBV related ACLF and 37 patients diagnosed with HBV related ACLF were collected for this retrospective study .The liver and kidney function ,HBV DNA level ,blood platelet count(BPC) ,coagulation function ,model for end-stage liver disease(MELD)score and mortality at 24 weeks were analyzed .Furthermore ,comparison of the clinical data between the survival patients and died patients in superinfection group was made .Unconditioned binary response logistic regression model was used to determine the corresponding risk factors .Results The level of total bilirubin(TBIL) ,MELD score ,incidence rate of hepatic encephalopathy and mortality at 24 weeks were signifi-cantly higher and prothrombin activity(PTA)was significantly lower in superinfection patients(P<0 .05) .The level of serum creat-inine(Cr) ,MELD score and incidence rate of hepatic encephalopathy were significantly higher and PTA was significantly lower in died patients than that of superinfection group(P< 0 .05) .Logistic regression analysis identified TBIL(P= 0 .024 ,OR= 1 .006) , BPC(P=0 .019 ,OR=0 .983) ,PTA(P=0 .001 ,OR=0 .795) ,MELD score(P=0 .005 ,OR=1 .497)and hepatic encephalopathy(P=0 .001 ,OR=4 .147)as prognostic factors for patients with superinfection of HEV and HBV related ACLF .Conclusion The clini-cal features of patients with superinfection of HEV and HBV related ACLF were more serious .The higher level of TBIL ,MELD score and hepatic encephalopathy and the lower level of BPC and PTA ,the worse prognosis .