Hepatology International

, Volume 4, Issue 3, pp 615–620

Comparison of effects of hepatitis E or A viral superinfection in patients with chronic hepatitis B

  • Xiaohong Zhang
  • Weimin Ke
  • Junqiang Xie
  • Zhixin Zhao
  • Dongying Xie
  • Zhiliang Gao
Original Article

DOI: 10.1007/s12072-010-9204-4

Cite this article as:
Zhang, X., Ke, W., Xie, J. et al. Hepatol Int (2010) 4: 615. doi:10.1007/s12072-010-9204-4

Abstract

Purpose

To compare the demographics, liver function, and prognosis of Chinese patients infected with chronic hepatitis B (CHB) and superinfected with hepatitis E virus (HEV) or hepatitis A virus (HAV).

Patients and methods

Among 188 patients with CHB, 136 with HEV superinfection and 52 with HAV superinfection were treated at our hospital between March 1999 and October 2007 for clinical features suggestive of acute hepatitis. The patients’ age, sex, incidence of liver failure, and mortality were recorded. The tested biochemical indices and markers of liver function included serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), prothrombin activity (PTA), and the serum levels of HBeAg, HBeAb, and HBV DNA.

Results

There were significant differences between the age and sex distributions of the two groups (P < 0.05). More patients in the CHB + HEV group had complications (94.9 vs. 61.5%, P < 0.001), and hepatic failure (39.7 vs. 11.5%, P = 0.002). Additionally, the mortality among the CHB + HEV group was significantly higher (33.8 vs. 1.9%, P < 0.001).

Conclusions

The comparison of clinical outcomes revealed that patients with HBV + HEV had more advanced baseline liver disease and a poorer prognosis than those with HBV + HAV. Because there is no vaccine against HEV, patients with CHB should take appropriate precautions against superinfection with HEV, such as consumption of boiled water and well-cooked food, in regions where it is endemic.

Keywords

Chronic hepatitis BHepatic failureHepatitis AHepatitis EMortalitySuperinfection

Copyright information

© Asian Pacific Association for the Study of the Liver 2010

Authors and Affiliations

  • Xiaohong Zhang
    • 1
  • Weimin Ke
    • 1
  • Junqiang Xie
    • 1
  • Zhixin Zhao
    • 1
  • Dongying Xie
    • 1
  • Zhiliang Gao
    • 1
  1. 1.Department of Infectious DiseasesThird Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouPeople’s Republic of China