Aggravating Effects of Hepatitis E Virus Infection on Patients with Chronic Liver Disease in Ibn-Sina Hospital Sudan
Ashraf Ismail *
Fedail Hospital, Sudan and Mubarak Alkabeer Hospital, Kuwait and University Hospital Sharjah, UAE.
Khalid A. Enan
Department of Virology, Central Laboratory, Ministry of Higher Education and Scientific Research, Khartoum, Sudan.
Abdel Rahim M. El-Hussein
Department of Virology, Central Laboratory, Ministry of Higher Education and Scientific Research, Khartoum, Sudan.
Hala Ibrahim
Ibn-Sina Hospital, Sudan.
Hajar A. Gsemalseed
Ibn-Sina Hospital, Sudan.
Abdel-Moniem Eltayeb Abdo
Ibn-Sina Hospital, Sudan.
*Author to whom correspondence should be addressed.
Abstract
Background: Hepatitis E virus (HEV) is one of the most common causes of acute hepatitis. Sudan is considered as hyper-endemic for HEV. HEV infection in patients with preexisting chronic liver diseases (CLDs) has been reported to result in severe clinical manifestations and poor outcomes. However data on the role of HEV infection in worsening of pre-existing CLD are limited.
Objective: To determine hepatitis E virus (HEV) infection and its effect on severity of CLD.
Methods: A descriptive cross-sectional study that consecutively enrolled 87 CLD patients in Ibn-Sina Specialized Hospital was carried out during the period from August 2020 to December 2020. Data regarding demographics, CLD causes, clinical manifestations and comorbidities were collected. The screening for anti-HEV antibodies was performed in all patients by using enzyme linked immuno-sorbent assay (ELISA).
Results: Hepatitis B virus (HBV) was the commonest etiology of chronic liver diseases being detected in 45/87(51.7%) patients. On the other hand;among all subjects; 43/87(49.4%) patients were HEV seropositive with anti-HEV Ig-G being detected in 32(36.8%) and concurrent anti-HEV Ig-M and Ig-G in 11(12.6%) patients. Jaundice (OR= 3.8, CI95%: 1.5-9.4; P. value=0.004), HCC (OR= 4.1, CI95%: 1.4-11.9; P. value=0.008), child-Pugh class-C (OR= 26, CI95%: 5.4-94.0; P. value=0.000) and child-Pugh class-B (OR= 5.3, CI95%: 1.6-17.0; P. value=0.000) were associated independently with anti-HEV positivity.
Conclusion: The frequency of hepatitis E virus (HEV) among Sudanese patients with chronic liver disease (CLD) was considerably high (mainly past infection- Ig-G). Furthermore, HEV was associated with advanced liver failure statuses (child-Pugh class-B & C), jaundice, and hepatocellular carcinoma.
Keywords: Hepatitis E virus, chronic liver diseases, ELISA, Ibn-Sina Hospital, Sudan