Hepatitis E virus as an etiology of acute exacerbation of previously unrecognized asymptomatic patients with hepatitis B virus‐related chronic liver disease

摘要: Background and Aim:  Hepatitis E virus (HEV) has recently been implicated in episodes of acute decompensation patients having underlying chronic liver disease (CLD) varying etiology. However, HEV as a cause exacerbation previously asymptomatic unrecognized hepatitis B (HBV)-infected is less well described. The aim the present study was to investigate etiology HBV-infected evaluate relative role HEV. We also investigated effect superinfection on clinical spectrum HBV infection. Methods:  Forty-three presented with following were retrospectively analyzed: (i) features suggestive hepatitis; (ii) surface antigen (HBsAg) (+); (iii) IgM core antibody (IgM anti-HBc) (−); (iv) no previous history disease; (v) CLD at presentation; (vi) HBsAg remaining (+) for least 12 months follow up; (vii) follow-up biopsy during convalescent phase showing evidence B. Results:  Of 43 patients, 21 e (HBeAg) (+) (Gr.1) 22 HBeAg (−) (Gr.2) presentation. In Gr.1, only two (9.5%) had (both A virus), whereas Gr.2, 11 (50%) (27.3% E, 13.6% 9.1% both) (P = 0.007). 19 (90.5%) spontaneous (immune clearance seroconversion) (due reactivation). Overall, contributed 20% and, particular, 36% initially patients. Time alanine aminotransferase normalization longer (n = 13) compared (n = 30) (median [range] 36 [8–48]vs 16 [6–36] weeks, P = 0.001). During convalescence, there significant difference between histological activity index score 8 [4–11]vs [4–16] P = 0.629) fibrosis scores 3.5 [1–4]vs 2 [1–4] P = 0.099] after recovery among due exacerbation. Conclusions:  Acute exacerbations HBeAg (+) are most often viral activation, while HBeAg (−) non-B viruses activation equally common. an important HBV-related CLD.