Hepatitis E Virus Infection In Patients With Chronic Hepatitis And Liver Cirrhosis Serum Epidemiological Study

Objective:To investigate retrospectively the serum anti-HEV IgG positive rate differences in patients with different types of chronic hepatitis(CH)and liver cirrhosis,and to explore the role of HEV infection in the progression of chronic liver diseases(CLD).Methods:We collected our hospital 1,751 cases of chronic hepatitis and liver cirrhosis patients from 2011 to 2016,and carried on the summary analysis of HEV antibodies(anti-HEV IgG positive,anti-HEV IgM negative)serum positive rate for these patients.Results:In CH patients anti-HEV antibody positive rate was 1.33%(13/981),and in cirrhotic patients anti-HEV IgG positive rate was 6.49%(50/770),the differences were statistically significant(P= 0.00).After Logistic regression model adjusted for age,patients that infected with HEV increased risk of cirrhosis than uninfected patients(OR= 4.78,95%CI:2.51-9.10).The comparison of positive rate of anti-HEV IgG positive rate between different types of chronic hepatitis and cirrhosis groups were as follows:chronic hepatitis B group 1.27%(10/790)versus HBV-related cirrhosis group 4.21%(22/522)(OR 3.04(1.36-6.77);P=0.00);chronic alcoholic hepatitis group 1.41%(1/71)versus alcoholic cirrhosis group 9.40%(11/117)(OR 8.00(1.00-64.25);P=0.03),chronic autoimmune hepatitis group 1.69%(1/59)versus autoimmune cirrhosis group 13.33%(12/90)(OR 13.11(1.49-115.27);P=0.01),the differences above were statistically significant.And chronic hepatitis C group 3.23%(1/31)versus HCV-related cirrhosis group 10.81%(4/37)(OR 4.40(0.45-43.53);P>0.05);chronic NASH group 0.00%(0/30)versus NASH-related cirrhosis group 25.00%(1/4)(P>0.05),the differences were not statistically significant.Anti-HEV IgG positive rate was also compared among different types of chronic hepatitis groups and found no significant difference.Likewise,anti-HEV IgG positive rate was compared among different types of cirrhotic groups,showing that the positive rates of both alcoholic cirrhosis(9.40%)and autoimmune cirrhosis(13.33%)were higher than that of HBV-related cirrhosis(4.21%),and the differences were statistically significant.Conclusion:Our study observed that the cirrhotic patients had a significantly higher anti-HEV IgG positive rate comparing with the CH patients,especially in those with HBV-related,alcohol-related and autoimmune-related cirrhosis.Additionally,it seems that the conditions of alcoholic cirrhosis and autoimmune cirrhosis are more susceptible to HEV infection.Therefore,the influence of HEV infection in CH and cirrhotic patients should be aware.And the HEV vaccination in these specific populations may obtain more benefits.