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

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  • Additional Information
    • Source:
      Publisher: Fundación Clínica Médica Sur Country of Publication: Mexico NLM ID: 101155885 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1665-2681 (Print) Linking ISSN: 16652681 NLM ISO Abbreviation: Ann Hepatol Subsets: MEDLINE
    • Publication Information:
      Publication: 2011- : México : Fundación Clínica Médica Sur
      Original Publication: México : Ediciones Medicina y Cultura, 2002-
    • Subject Terms:
      Hepatitis E virus* ; Superinfection*/complications ; Hepatitis B, Chronic*/complications ; Hepatitis B, Chronic*/diagnosis ; Hepatitis E*/complications ; Hepatitis E*/diagnosis ; Hepatitis E*/epidemiology ; Hepatitis B*/complications ; Hepatitis B*/diagnosis ; Acute-On-Chronic Liver Failure*; Humans ; Aged ; Hepatitis B virus ; Retrospective Studies ; Liver Cirrhosis/complications ; Disease Progression ; Acute Disease
    • Abstract:
      Introduction and Objectives: Hepatitis E virus (HEV) superinfection is a common excerbating event in patients with chronic hepatitis B, but the impact on the long-term prognosis is not clear. This study investigates the specific role of HEV superinfection in the long-term outcome of hepatitis B virus (HBV) patients with liver cirrhosis.
      Patients and Methods: A retrospective, observational cohort study was conducted using clinical, laboratory, and survival data collected from patients suffering from hepatitis B cirrhosis with or without HEV superinfection. Disease progression and mortality rates were analyzed.
      Results: After a two-year follow-up, HEV superinfection was identified in 27 of 811 patients. The transplantation-free mortality was significantly increased (51.9% vs. 14.3%, p< 0.001) in HEV superinfection compared to that in hepatitis B cirrhosis patients without HEV superinfection. Logistic regression analysis demonstrated that elderly people were independent host risk factors for hepatitis B cirrhosis patients with HEV superinfection before and after propensity score matching (PSM). Moreover, HEV superinfection was a risk factor for patients with hepatitis B cirrhosis with new acute decompensation (AD) and acute-on-chronic liver failure (ACLF) during hospitalization. A multivariate Cox proportional hazards regression model demonstrated that acute HEV co-infection is associated with two-year mortality (hazard ratio [HR]: 2.49; 95% CI: 1.40-4.43; p= 0.002; and HR: 5.79; 95% CI: 1.87-17.87; p= 0.002) in patients with hepatitis B cirrhosis before and after PSM.
      Conclusions: Elder patients with hepatitis B cirrhosis are susceptible to HEV superinfection, accelerating disease progression and increasing long-term mortality in hospitalized patients with HBV-related decompensated liver cirrhosis.
      Competing Interests: Declaration of interest None.
      (Copyright © 2022 Fundación Clínica Médica Sur, A.C. Published by Elsevier España, S.L.U. All rights reserved.)
    • Contributed Indexing:
      Keywords: Co-infection; Decompensation; Disease progression; Mortality; Viral hepatitis
    • Publication Date:
      Date Created: 20221123 Date Completed: 20230320 Latest Revision: 20230320
    • Publication Date:
      20230320
    • Accession Number:
      10.1016/j.aohep.2022.100878
    • Accession Number:
      36417965