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Influence of chronic HBV infection on superimposed acute hepatitis E

Si-Hong Cheng1, Li Mai, Feng-Qin Zhu

  • 1Si-Hong Cheng, Li Mai, Feng-Qin Zhu, Xing-Fei Pan, Hai-Xia Sun, Hong Cao, Xin Shu, Wei-Min Ke, Gang Li, Qi-Huan Xu, Department of Infectious Diseases, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China.

World Journal of Gastroenterology
|October 15, 2013
PubMed

Insights

Chronic hepatitis B virus (HBV) infection with superimposed acute hepatitis E leads to worse outcomes, especially with underlying cirrhosis. Anti-HBV treatment does not improve liver failure prognosis in these cases.

Area of Science:

  • Hepatology
  • Virology
  • Infectious Diseases

Background:

  • Chronic hepatitis B virus (HBV) infection is a global health concern.
  • Hepatitis E virus (HEV) infection can cause acute liver inflammation.
  • Superinfection of chronic HBV with acute HEV presents unique clinical challenges.

Purpose of the Study:

  • To evaluate the clinical impact of superimposed acute hepatitis E on patients with chronic hepatitis B virus infection.
  • To assess the influence of hepatitis B e antigen (HBeAg), HBV DNA levels, and cirrhosis on outcomes.
  • To determine the efficacy of anti-HBV treatment in managing HBV-HEV superinfection.

Main Methods:

  • Retrospective analysis of 294 patients, divided into HBV + HEV and HEV groups.
  • Comparison of clinical features, including liver function tests and disease severity scores.
  • Statistical analysis using chi-squared test, Fisher's exact test, and Student's t-test.

Main Results:

  • The HBV + HEV group exhibited significantly higher peak prothrombin time, total bilirubin, and MELD scores.
  • Complications, liver failure incidence, and mortality were substantially increased in the HBV + HEV group compared to the HEV group.
  • Underlying cirrhosis in chronic HBV patients significantly worsened complication and liver failure rates during acute HEV superinfection.

Conclusions:

  • Underlying cirrhosis in chronic HBV infection exacerbates clinical severity and outcomes of superimposed acute hepatitis E.
  • Anti-HBV therapy does not improve the prognosis of liver failure resulting from HBV-HEV superinfection.
Abstract

Keywords:
Acute hepatitis EAnti-hepatitis B virus treatmentChronic hepatitis B virus infectionClinical profileSuperinfection

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