Influence of hepatitis E virus infection on the severity of chronic hepatitis C patients

Abstract

Abstract: Objective To evaluate the prevalence of HEV infection in patients with chronic hepatitis C (CHC) and its influence on the severity and the incidence of liver fibrosis.Methods A total of 184 patients with CHC were collected from January 2016 to October 2021, including 86 males and 98 females, with an average age of 60 (31, 80) years old. Patients with CHC were divided into simple CHC group and HEV group according to whether they were infected with HEV. The general data and pathological results of the two groups of patients were compared.Results 22 cases (11.9%) of CHC patients were positive for anti-HEV-IgM, 3 cases (1.6%) were positive for anti-HEV-IgM, and 1 case (0.5%) was positive for both anti-HEV-IgM and anti-HEV-IgG. The infection rate of HEV was 14.1% (26/184). Compared with clinical data, the average age of simple CHC group was 60 (31, 70) years old, which was significantly lower than that of HEV group [66 (52, 80), P<0.05]. Compared with HEV group [14 cases (53.8%)], the proportion of diabetes in CHC group alone was significantly lower [33 cases (20.9%), P<0.05]; the PLT of simple CHC group was 182 (111, 304) ×10⁹/L, which was significantly higher than that of HEV group [116 (70, 192) ×10⁹/L, P<0.05]. The ALT and TBil in CHC group were 111 (81, 194) U/L and 124.2 (70.8, 255.5) μmol/L, which were lower than those in HEV group [163 (102, 321) U/L and 204.8 (110.6, 375.0) μmol/L, respectively. HA, pIIINP, c-IV and LN in CHC group were 126 (86, 190) ng/mL, 8.7 (6.0, 13.4) ng/mL, 118 (74, 168) ng/mL and 112 (93, 128) ng/mL, which were lower than those of 310 (178, 502) ng/mL, 24.4 (17.2, 27.0) ng/mL, 292 (144, 380) ng/mL and 130 (114, 175) ng/mL in the combined HEV group (P<0.05). The duration and course of jaundice in CHC group were 26 (18, 40) days and 26.5 (22.0, 33.5) months, which were significantly shorter than those in HEV group [38 (33, 52) days and 45.0 (38.5, 55.0) months, P<0.05].Conclusion In HCV infected patients, the positive rate of HEV serum is high, while the degree of liver fibrosis is higher and the clinical outcome is worse. HEV screening should be routinely carried out in HCV infected patients.

Key words: Chronic hepatitis C, Hepatitis E virus, Hyaluronic acid

LIU Huang-cun, LI You-lei, LIU Yong-cheng. Influence of hepatitis E virus infection on the severity of chronic hepatitis C patients[J]. Chinese Hepatolgy, 2023, 28(5): 537-540.

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