Investigation On The Positive Rate Of Anti-HEV-IgG Serotypes In Patients With Chronic Hepatitis B In Northeast Sichuan Analysis Of 33 Cases Of Hepatitis B Superinfection With Hepatitis E

Objective:To investigate the positive rate of anti-HEV-IgG in patients with chronic hepatitis B(chronic hepatitis B,CHB)in northern Sichuan,and to analyze the influence of chronic hepatitis B superinfection with hepatitis E virus(HBV-HEV superinfection)on clinical condition and prognosis.Methods:1.1008 patients diagnosed as chronic hepatitis B in the Department of Infection Affiliated Hospital of North Sichuan Medical College from January to December 2020 were selected as the experimental group,and 401 healthy physical examination populations in this hospital were selected As a control group,basic information and serum samples were collected,and anti-HEV-IgG in serum was detected by enzyme-linked immunosorbent assay.2.Analyze the clinical characteristics of 33 patients with chronic hepatitis B combined with acute hepatitis E virus infection,and compare them with 30 patients with acute hepatitis E.Use SPSS22.0 statistical software to perform statistical analysis on the data.Results:1.The positive rate of Anti-HEV-IgG and age、gender distribution of CHB patients577 anti-HEV-IgG test results in 1008 cases were positive,the positive rate was 57.2%,385 of 651 men,resulting in a positive rate of 59.1%,and 192 of 357 women,resulting in a positive rate of 53.8%;401 healthy control Of the 235 cases of anti-HEV-IgG,the positive rate was 58.6%,158 of the 256 men tested positive,the positive rate was 61.7%,77 of the 145 women tested positive,the positive rate was 53.2%;the two groups were anti-HEV-IgG There was no difference in the positive rate(P>0.05),and there was no difference in the positive rate of anti-HEV-IgG between men and women in the two groups(P>0.05).After comparing the hepatitis B group and the healthy control group by age,the results showed that there was no difference in the anti-HEV-IgG positive rate between the two groups in the same age group(P>0.05);the seropositivity rate of the two groups increased with age(P<0.01)),the positive rate of anti-HEV-IgG was higher in the age group over 40 years old.2.The basic and clinical characteristics of inclsion casesThe age and gender distribution of 33 cases of HBV-HEV superinfection group and 30 cases of acute hepatitis E group were basically the same(P>0.05).There were more men than women,and the average age of onset was about 51 years old.Acute hepatitis E is sporadic throughout the year,with the highest incidence in the first quarter,accounting for 49.2%of all cases;and the lowest in the third quarter,accounting for 12.7%of all cases.There was no significant difference between the HBV-HEV superinfection group and the acute hepatitis E group in the incidence of fatigue,gastrointestinal symptoms,jaundice,fever and other clinical symptoms.There was no significant difference in the elevation of ALT,AST,total bilirubin,direct bilirubin,and total bile acid between the two groups(P>0.05);but the superinfection group had significant serum ALB,prothrombin activity and platelet count Lower than the acute hepatitis E group,there is a significant difference(P<0.05).Among the 33 patients in the superinfection group,11 had liver failure,with an incidence rate of 33%;7 of the 11 patients with liver failure(63.6%)did not respond to treatment;none of the 30 patients in the acute hepatitis E group had liver failure.The HBV-DNA level of 18 cases(54.5%)in the 33 superinfection group was lower than the lower limit of the detection value.There was no significant difference in the HBV-DNA level between the liver failure group and the non-liver failure group(P>0.05).Among the complications of liver failure,the incidence of primary peritonitis was the highest(72.7%),followed by hepatic encephalopathy(36.4%),gastrointestinal bleeding(18.2%),and hepatorenal syndrome(9.1%).Conclusion:1.The positive rate of anti-HEV-IgG in healthy people in northern Sichuan is 58.6%,which is higher than reported in other parts of the country.2.The positive rate of anti-HEV-IgG in the chronic hepatitis B population in northern Sichuan is 57.2%,which is no difference compared with the healthy population.3.The incidence of liver failure is higher in HBV-HEV superinfection,and the clinical prognosis of patients with liver failure is poor.