A clinical analysis of 221 patients with acute hepatitis E

AIM: To investigate and analyze clinical characteristics of patients with acute hepatitis E infection.

METHODS: Epidemiological data of 221 patients with acute hepatitis E infection were collected. Comparisons were performed to find the differences in disease course, biochemical index and prognosis amongst diverse age groups (below 18-years-old, between 18 and 60, above 60), different status of disease groups (hepatitis E infection only, hepatitis E infection accompanied by hepatitis B infection/alcohol hepatitis), and different antibody groups (anti-HEV-IgG positive, anti-HEV-IgM positive).

RESULTS: 84.8% (188/221) of patients were over 18 years old, and the ratio of male/female was 3.92:1. Then the characteristics of occupation distribution were people working outside, 108 patients (48.8%) in this group. In addition, season was another factor that influenced hepatitis E infection, especially from February to May during which there were 67.8% patients infected with hepatitis E. The clinical features were summarized into three points: prolonged disease course, an increased mortality and decreased levels of ALT/ALB were associated with older age. Second, the prevalence of severe liver disease and mortality in the group of hepatitis E infection accompanied by hepatitis B (7.8%, 1.9%) and alcohol hepatitis (6.0%, 3.0%) were higher than those in hepatitis E infection group (2.1%, 0.7%). In addition, there was no significant difference in clinical symptoms and biochemical indexes between anti-HEV-IgG positive and anti-HEV-IgM positive groups.

CONCLUSION: Four epidemiological characteristics, including adult, male, people working outside and winter/spring, are found to be associated with hepatitis E infection. The prognosis of disease in the majority of patients is favorable, old age and coexistence with hepatitis B and alcohol hepatitis can be seen as the factors which affect the prognosis.