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

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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.

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References

  1. Chinese Center for Disease Control and Prevention website: http://www.chinacdc.net.

  2. Xiong LS, Cui SF, Zhou JG, Xing Y. Detection and analysis of HAV-HEV, HGV infection in patients with viral hepatitis. Zhonghua Gan Zang Bing Za Zhi 2004;12:395–396 (in Chinese, with English abstract)

    PubMed  Google Scholar 

  3. Vento S, Garofano T, Renzini C, Cainelli F, Casali F, Ghironzi G, Ferraro T, Concia E. Fulminant hepatitis associated with hepatitis A virus superinfection in patients with chronic hepatitis C. N Engl J Med 1998;338:286–290

    Article  CAS  PubMed  Google Scholar 

  4. Hamid SS, Atiq M, Shehzad F, Yasmeen A, Nissa T, Salam A, Siddiqui A, Jafri W. Hepatitis E superinfection in patients with chronic liver disease. Hepatology 2002;36:474–478

    Article  PubMed  Google Scholar 

  5. Ke WM, Li XJ, Yu LN, Lai J, Li XH, Gao ZL, Chen PJ. Etiological investigation of fatal liver failure during the course of chronic hepatitis B in southeast China. J Gastroenterol 2006;41:347–351

    Article  PubMed  Google Scholar 

  6. Protocol of prevention and treatment in viral hepatitis. Chin J Hepatol (Chinese) 2000; 8: 324–333

  7. Liang XF, Chen YS, Wang XJ, He X, Chen LJ, Wang J, Lin CY, Bai HQ, Yan J, Cui G, Yu JJ. A study on the sero-epidemiology of hepatitis B in Chinese population aged over 3-years old. Chin J Epidemiol 2005;26:655–658

    Google Scholar 

  8. Zhang GS, Feng FM, Li YL, Yuan JX, Shang H. A study of chronic hepatitis B infection superinfected with hepatitis E infection. Zhonghua Gan Zang Bing Za Zhi 2006;14:906–908 (in Chinese, with English abstract)

    CAS  PubMed  Google Scholar 

  9. Kumar M, Sharma BC, Sarin SK. Hepatitis E virus as an etiology of acute exacerbation of previously unrecognized asymptomatic patients with hepatitis B virus-related chronic liver disease. J Gastroenterol Hepatol 2008;23:883–887

    Article  PubMed  Google Scholar 

  10. Kumar Acharya S, Kumar Sharma P, Singh R, Kumar Mohanty S, Madan K, Kumar Jha J, Kumar Panda S. Hepatitis E virus (HEV) infection in patients with cirrhosis is associated with rapid decompensation and death. J Hepatol 2007;46:387–394

    Article  PubMed  Google Scholar 

  11. Keefe EB. Hepatitis A and B superimposed on chronic liver disease: vaccine-preventable diseases. Trans Am Clin Climatol Assoc 2006;117:227–268

    Google Scholar 

  12. Xiaodan Z, Weimin K, Hong C, Ying Z, Yangsu H. Clinical disease features of sporadic hepatitis A affected by chronic infection of hepatitis B virus. Chin J Coal Ind Med 2003;6:100–101

    Google Scholar 

  13. Xiangming X, Hong C, Hong D, Yangsu H, Weimin K. Effect of basis on chronic infection of hepatitis B virus on clinical features of sporadic hepatitis E. Pract Prevent Med 2000;7:247–249

    Google Scholar 

  14. Sainokami S, Abe K, Kumagai I, Miyasaka A, Endo R, Takikawa Y. Epidemiological and clinical study of sporadic acute hepatitis E caused by indigenous strains of hepatitis E virus in Japan compared with acute hepatitis A. J Gastroenterol 2004;39:640–648

    Article  PubMed  Google Scholar 

  15. Mahtab MA, Rahman S, Khan M, Mamun AA, Afroz S. Etiology of fulminant hepatic failure: experience from a tertiary hospitals in Bangladesh. Hepatobiliary Pancreat Dis Int 2008;7:161–164

    PubMed  Google Scholar 

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Correspondence to Xiaohong Zhang.

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Zhang, X., Ke, W., Xie, J. et al. Comparison of effects of hepatitis E or A viral superinfection in patients with chronic hepatitis B. Hepatol Int 4, 615–620 (2010). https://doi.org/10.1007/s12072-010-9204-4

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  • DOI: https://doi.org/10.1007/s12072-010-9204-4

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