1. Superinfective Hepatitis E Virus Infection Aggravates Hepatocytes Injury in Chronic Hepatitis B.
- Author
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Kilonzo SB, Wang YL, Jiang QQ, Wu WY, Wang P, Ning Q, and Han MF
- Subjects
- Acute-On-Chronic Liver Failure complications, Acute-On-Chronic Liver Failure immunology, Acute-On-Chronic Liver Failure pathology, Adult, Aged, Alanine Transaminase blood, Alanine Transaminase immunology, Ascites complications, Ascites immunology, Ascites pathology, Bilirubin blood, Bilirubin immunology, China, Female, Hepatic Encephalopathy complications, Hepatic Encephalopathy immunology, Hepatic Encephalopathy pathology, Hepatitis Antibodies blood, Hepatitis B virus immunology, Hepatitis B virus pathogenicity, Hepatitis B, Chronic complications, Hepatitis B, Chronic immunology, Hepatitis B, Chronic pathology, Hepatitis E complications, Hepatitis E immunology, Hepatitis E pathology, Hepatitis E virus immunology, Hepatitis E virus pathogenicity, Hepatocytes immunology, Hepatocytes pathology, Hepatocytes virology, Hepatorenal Syndrome complications, Hepatorenal Syndrome immunology, Hepatorenal Syndrome pathology, Humans, Immunoglobulin G blood, Interleukin-10 blood, Interleukin-10 immunology, Interleukin-6 blood, Interleukin-6 immunology, Liver immunology, Liver pathology, Liver virology, Liver Cirrhosis complications, Liver Cirrhosis immunology, Liver Cirrhosis pathology, Male, Middle Aged, Retrospective Studies, Superinfection complications, Superinfection immunology, Superinfection pathology, Tumor Necrosis Factor-alpha blood, Tumor Necrosis Factor-alpha immunology, Acute-On-Chronic Liver Failure virology, Ascites virology, Hepatic Encephalopathy virology, Hepatitis B, Chronic virology, Hepatitis E virology, Hepatorenal Syndrome virology, Liver Cirrhosis virology, Superinfection virology
- Abstract
Hepatitis E virus (HEV) infection is a major cause of morbidity in endemic areas. Its consequences among chronic hepatitis B (CHB) patients have been under-reported. The aim of this study was to assess the impact of superinfective HEV infection (acute and past) on virological and clinical features of patients with CHB infection. Clinical, biochemical, virological and immunological data of 153 CHB patients including 98 with hepatitis B virus (HBV) monoinfection and 55 with HBV-HEV superinfection with both HEV and HBV infection was retrospectively investigated and analyzed in this study conducted in Wuhan, China. An overall anti-HEV IgG seroprevalence was found to be 35.9% in CHB patients. HBV-HEV superinfection patients showed significantly higher rate of complications (ascites, hepato-renal syndrome & encephalopathy) (all with P=0.04), cirrhosis (P<0.001) and acute-on-chronic liver failure (P<0.001) than HBV monoinfection patients. They also displayed elevated ALTs (P<0.001) and total serum bilirubin (P<0.001) with diminished albumin (P<0.001) and HBV viral load (P<0.001). Cytokines assay revealed increased expression of IL-6 (P=0.02), IL-10 (P=0.009) and TNF-α (P=0.003) in HBV-HEV superinfection patients compared to HBV monoinfection patients. Our study demonstrated that HEV superinfection in CHB patients was associated with progressive clinical manifestation, which is likely due to the enhanced expression of cytokines related with hepatocytes necrosis. HEV was also associated with repressed HBV replication, but the underlying mechanism requires further investigation.
- Published
- 2019
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