Hepatitis E virus (HEV) infection in patients with cirrhosis is associated with rapid decompensation and death
Background/Aims India is hyper-endemic for hepatitis E virus (HEV). HEV infection in cirrhosis may cause high mortality. Prospective study evaluating HEV infection in cirrhotics is scarce. Methods Consecutive patients with cirrhosis and healthy controls were included. Cirrhotics were categorized to...
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| Veröffentlicht in: | Journal of hepatology 2007-03, Vol.46 (3), p.387-394 |
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| container_title | Journal of hepatology |
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| creator | Kumar Acharya, Subrat Kumar Sharma, Praveen Singh, Rajbir Kumar Mohanty, Sujit Madan, Kaushal Kumar Jha, Jyotish Kumar Panda, Subrat |
| description | Background/Aims India is hyper-endemic for hepatitis E virus (HEV). HEV infection in cirrhosis may cause high mortality. Prospective study evaluating HEV infection in cirrhotics is scarce. Methods Consecutive patients with cirrhosis and healthy controls were included. Cirrhotics were categorized to 3 groups, (Group I – rapid decompensation, Group II – chronically decompensated, Group III – cirrhotics without decompensation). Sera from cirrhotics and controls were tested for HEV-RNA (RT-PCR). HEV-RNA positivity among cirrhotics and controls was compared. Natural course and mortality rate between HEV infected and non-infected cirrhotics were assessed during a 12-month follow-up. Results 107 cirrhotics and 200 controls were included. 30 (28%) cirrhotics and 9 (4.5%) controls had detectable HEV-RNA ( p < 0.001). HEV- RNA positivity among Group I ( n = 42), II ( n = 32) and III ( n = 33) cirrhotics was 21 (50%), 6 (19%) and 3 (10%), respectively ( p = 0.002). 70% (21/30) with HEV infection and 27% (21/77) without it had rapid decompensation ( p = 0.001). Mortality between HEV infected and non-infected cirrhotics at 4 weeks (43% vs. 22%, p = 0.001) and 12 month (70% vs. 30%, p = 0.001) was different. Multivariate analysis identified HEV infection, Child-Pugh’s score, renal failure, and sepsis as independent factors for mortality. Conclusions In India, cirrhotics were prone to HEV infection, which was associated with rapid decompensation and death. |
| doi_str_mv | 10.1016/j.jhep.2006.09.016 |
| format | Article |
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HEV infection in cirrhosis may cause high mortality. Prospective study evaluating HEV infection in cirrhotics is scarce. Methods Consecutive patients with cirrhosis and healthy controls were included. Cirrhotics were categorized to 3 groups, (Group I – rapid decompensation, Group II – chronically decompensated, Group III – cirrhotics without decompensation). Sera from cirrhotics and controls were tested for HEV-RNA (RT-PCR). HEV-RNA positivity among cirrhotics and controls was compared. Natural course and mortality rate between HEV infected and non-infected cirrhotics were assessed during a 12-month follow-up. Results 107 cirrhotics and 200 controls were included. 30 (28%) cirrhotics and 9 (4.5%) controls had detectable HEV-RNA ( p < 0.001). HEV- RNA positivity among Group I ( n = 42), II ( n = 32) and III ( n = 33) cirrhotics was 21 (50%), 6 (19%) and 3 (10%), respectively ( p = 0.002). 70% (21/30) with HEV infection and 27% (21/77) without it had rapid decompensation ( p = 0.001). Mortality between HEV infected and non-infected cirrhotics at 4 weeks (43% vs. 22%, p = 0.001) and 12 month (70% vs. 30%, p = 0.001) was different. Multivariate analysis identified HEV infection, Child-Pugh’s score, renal failure, and sepsis as independent factors for mortality. Conclusions In India, cirrhotics were prone to HEV infection, which was associated with rapid decompensation and death.</description><identifier>ISSN: 0168-8278</identifier><identifier>EISSN: 1600-0641</identifier><identifier>DOI: 10.1016/j.jhep.2006.09.016</identifier><identifier>PMID: 17125878</identifier><identifier>CODEN: JOHEEC</identifier><language>eng</language><publisher>Oxford: Elsevier B.V</publisher><subject>Adult ; Biological and medical sciences ; Case-Control Studies ; Cirrhosis ; Death ; Decompensation ; Disease Progression ; Female ; Gastroenterology and Hepatology ; Gastroenterology. Liver. Pancreas. Abdomen ; Hepatitis E - complications ; Hepatitis E - etiology ; Hepatitis E - mortality ; Hepatitis E virus - genetics ; Hepatitis E virus - pathogenicity ; HEV ; Human viral diseases ; Humans ; India - epidemiology ; Infectious diseases ; Kaplan-Meier Estimate ; Liver Cirrhosis - complications ; Liver Cirrhosis - mortality ; Liver Cirrhosis - virology ; Liver Failure - etiology ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical sciences ; Middle Aged ; Other diseases. Semiology ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; RNA, Viral - blood ; Survival Rate ; Viral diseases ; Viral hepatitis</subject><ispartof>Journal of hepatology, 2007-03, Vol.46 (3), p.387-394</ispartof><rights>European Association for the Study of the Liver</rights><rights>2006 European Association for the Study of the Liver</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-4a3aec54bf981a35366be234db93dc60a648fc4a476660f630a3ce92f779fdcd3</citedby><cites>FETCH-LOGICAL-c439t-4a3aec54bf981a35366be234db93dc60a648fc4a476660f630a3ce92f779fdcd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jhep.2006.09.016$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18525755$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17125878$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kumar Acharya, Subrat</creatorcontrib><creatorcontrib>Kumar Sharma, Praveen</creatorcontrib><creatorcontrib>Singh, Rajbir</creatorcontrib><creatorcontrib>Kumar Mohanty, Sujit</creatorcontrib><creatorcontrib>Madan, Kaushal</creatorcontrib><creatorcontrib>Kumar Jha, Jyotish</creatorcontrib><creatorcontrib>Kumar Panda, Subrat</creatorcontrib><title>Hepatitis E virus (HEV) infection in patients with cirrhosis is associated with rapid decompensation and death</title><title>Journal of hepatology</title><addtitle>J Hepatol</addtitle><description>Background/Aims India is hyper-endemic for hepatitis E virus (HEV). HEV infection in cirrhosis may cause high mortality. Prospective study evaluating HEV infection in cirrhotics is scarce. Methods Consecutive patients with cirrhosis and healthy controls were included. Cirrhotics were categorized to 3 groups, (Group I – rapid decompensation, Group II – chronically decompensated, Group III – cirrhotics without decompensation). Sera from cirrhotics and controls were tested for HEV-RNA (RT-PCR). HEV-RNA positivity among cirrhotics and controls was compared. Natural course and mortality rate between HEV infected and non-infected cirrhotics were assessed during a 12-month follow-up. Results 107 cirrhotics and 200 controls were included. 30 (28%) cirrhotics and 9 (4.5%) controls had detectable HEV-RNA ( p < 0.001). HEV- RNA positivity among Group I ( n = 42), II ( n = 32) and III ( n = 33) cirrhotics was 21 (50%), 6 (19%) and 3 (10%), respectively ( p = 0.002). 70% (21/30) with HEV infection and 27% (21/77) without it had rapid decompensation ( p = 0.001). Mortality between HEV infected and non-infected cirrhotics at 4 weeks (43% vs. 22%, p = 0.001) and 12 month (70% vs. 30%, p = 0.001) was different. Multivariate analysis identified HEV infection, Child-Pugh’s score, renal failure, and sepsis as independent factors for mortality. Conclusions In India, cirrhotics were prone to HEV infection, which was associated with rapid decompensation and death.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>Cirrhosis</subject><subject>Death</subject><subject>Decompensation</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Gastroenterology and Hepatology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Hepatitis E - complications</subject><subject>Hepatitis E - etiology</subject><subject>Hepatitis E - mortality</subject><subject>Hepatitis E virus - genetics</subject><subject>Hepatitis E virus - pathogenicity</subject><subject>HEV</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>India - epidemiology</subject><subject>Infectious diseases</subject><subject>Kaplan-Meier Estimate</subject><subject>Liver Cirrhosis - complications</subject><subject>Liver Cirrhosis - mortality</subject><subject>Liver Cirrhosis - virology</subject><subject>Liver Failure - etiology</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Other diseases. Semiology</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>RNA, Viral - blood</subject><subject>Survival Rate</subject><subject>Viral diseases</subject><subject>Viral hepatitis</subject><issn>0168-8278</issn><issn>1600-0641</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kl2L1DAUhoMo7uzqH_BCeqPoRWvSpGkKIsgy6wgLXvhxGzLJKZPaSWtOurL_3tQZWPBCCCS8ec5JeDiEvGC0YpTJd0M1HGCuakplRbsqR4_IhklKSyoFe0w2OVGlqlt1QS4RB0opp514Si5Yy-pGtWpDwg5mk3zyWGyLOx8XLN7stj_eFj70YJOfQj4VKwIhYfHbp0NhfYyHCXNJXgZxst4kcKfLaGbvCgd2Os4Q0PxtYcIamXR4Rp70ZkR4ft6vyPeb7bfrXXn75dPn64-3pRW8S6Uw3IBtxL7vFDO84VLuoebC7TvurKRGCtVbYUQrpaS95NRwC13dt23XO-v4FXl96jvH6dcCmPTRo4VxNAGmBbVUXdsIqTJYn0AbJ8QIvZ6jP5p4rxnVq2U96NWyXi1r2ukc5aKX5-7L_gjuoeSsNQOvzoBBa8Y-mmA9PnCqqZu2aTL3_sRBdnHnIWq0WbQF52O2r93k__-PD_-U29EHn1_8CfeAw7TEkC1rprHWVH9d52EdB5pnpJGi5n8ABxexAw</recordid><startdate>20070301</startdate><enddate>20070301</enddate><creator>Kumar Acharya, Subrat</creator><creator>Kumar Sharma, Praveen</creator><creator>Singh, Rajbir</creator><creator>Kumar Mohanty, Sujit</creator><creator>Madan, Kaushal</creator><creator>Kumar Jha, Jyotish</creator><creator>Kumar Panda, Subrat</creator><general>Elsevier B.V</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20070301</creationdate><title>Hepatitis E virus (HEV) infection in patients with cirrhosis is associated with rapid decompensation and death</title><author>Kumar Acharya, Subrat ; Kumar Sharma, Praveen ; Singh, Rajbir ; Kumar Mohanty, Sujit ; Madan, Kaushal ; Kumar Jha, Jyotish ; Kumar Panda, Subrat</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-4a3aec54bf981a35366be234db93dc60a648fc4a476660f630a3ce92f779fdcd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Case-Control Studies</topic><topic>Cirrhosis</topic><topic>Death</topic><topic>Decompensation</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Gastroenterology and Hepatology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Hepatitis E - complications</topic><topic>Hepatitis E - etiology</topic><topic>Hepatitis E - mortality</topic><topic>Hepatitis E virus - genetics</topic><topic>Hepatitis E virus - pathogenicity</topic><topic>HEV</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>India - epidemiology</topic><topic>Infectious diseases</topic><topic>Kaplan-Meier Estimate</topic><topic>Liver Cirrhosis - complications</topic><topic>Liver Cirrhosis - mortality</topic><topic>Liver Cirrhosis - virology</topic><topic>Liver Failure - etiology</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Other diseases. Semiology</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>RNA, Viral - blood</topic><topic>Survival Rate</topic><topic>Viral diseases</topic><topic>Viral hepatitis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kumar Acharya, Subrat</creatorcontrib><creatorcontrib>Kumar Sharma, Praveen</creatorcontrib><creatorcontrib>Singh, Rajbir</creatorcontrib><creatorcontrib>Kumar Mohanty, Sujit</creatorcontrib><creatorcontrib>Madan, Kaushal</creatorcontrib><creatorcontrib>Kumar Jha, Jyotish</creatorcontrib><creatorcontrib>Kumar Panda, Subrat</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kumar Acharya, Subrat</au><au>Kumar Sharma, Praveen</au><au>Singh, Rajbir</au><au>Kumar Mohanty, Sujit</au><au>Madan, Kaushal</au><au>Kumar Jha, Jyotish</au><au>Kumar Panda, Subrat</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hepatitis E virus (HEV) infection in patients with cirrhosis is associated with rapid decompensation and death</atitle><jtitle>Journal of hepatology</jtitle><addtitle>J Hepatol</addtitle><date>2007-03-01</date><risdate>2007</risdate><volume>46</volume><issue>3</issue><spage>387</spage><epage>394</epage><pages>387-394</pages><issn>0168-8278</issn><eissn>1600-0641</eissn><coden>JOHEEC</coden><abstract>Background/Aims India is hyper-endemic for hepatitis E virus (HEV). HEV infection in cirrhosis may cause high mortality. Prospective study evaluating HEV infection in cirrhotics is scarce. Methods Consecutive patients with cirrhosis and healthy controls were included. Cirrhotics were categorized to 3 groups, (Group I – rapid decompensation, Group II – chronically decompensated, Group III – cirrhotics without decompensation). Sera from cirrhotics and controls were tested for HEV-RNA (RT-PCR). HEV-RNA positivity among cirrhotics and controls was compared. Natural course and mortality rate between HEV infected and non-infected cirrhotics were assessed during a 12-month follow-up. Results 107 cirrhotics and 200 controls were included. 30 (28%) cirrhotics and 9 (4.5%) controls had detectable HEV-RNA ( p < 0.001). HEV- RNA positivity among Group I ( n = 42), II ( n = 32) and III ( n = 33) cirrhotics was 21 (50%), 6 (19%) and 3 (10%), respectively ( p = 0.002). 70% (21/30) with HEV infection and 27% (21/77) without it had rapid decompensation ( p = 0.001). Mortality between HEV infected and non-infected cirrhotics at 4 weeks (43% vs. 22%, p = 0.001) and 12 month (70% vs. 30%, p = 0.001) was different. Multivariate analysis identified HEV infection, Child-Pugh’s score, renal failure, and sepsis as independent factors for mortality. Conclusions In India, cirrhotics were prone to HEV infection, which was associated with rapid decompensation and death.</abstract><cop>Oxford</cop><pub>Elsevier B.V</pub><pmid>17125878</pmid><doi>10.1016/j.jhep.2006.09.016</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences Case-Control Studies Cirrhosis Death Decompensation Disease Progression Female Gastroenterology and Hepatology Gastroenterology. Liver. Pancreas. Abdomen Hepatitis E - complications Hepatitis E - etiology Hepatitis E - mortality Hepatitis E virus - genetics Hepatitis E virus - pathogenicity HEV Human viral diseases Humans India - epidemiology Infectious diseases Kaplan-Meier Estimate Liver Cirrhosis - complications Liver Cirrhosis - mortality Liver Cirrhosis - virology Liver Failure - etiology Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Middle Aged Other diseases. Semiology Proportional Hazards Models Prospective Studies Risk Factors RNA, Viral - blood Survival Rate Viral diseases Viral hepatitis |
| title | Hepatitis E virus (HEV) infection in patients with cirrhosis is associated with rapid decompensation and death |
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