ABSTRACT
OBJECTIVE: The study aims to analyze the epidemiological characteristics and clinical features of sporadic viral hepatitis E. METHODS: The 1,000 cases of sporadic viral hepatitis E patients treated in 20 hospitals from May 2013 to May 2016 were selected as research subjects, with their clinical data retrospectively analyzed. RESULTS: (1) Epidemiological characteristics: Seen from the disease time, the 1,000 patients have morbidity throughout the year, but morbidity in hot and rainy summer is significantly higher than other seasons, there exists statistically difference in comparison between the groups (P<0.05); sporadic viral hepatitis E has no family aggregation; male morbidity is greater than female. In the study, there were male 782 cases, 218 female cases, with male/female ratio at 3.6: 1; morbidity was 13.7% (137/1000) for patients under 18, 62.9% (629/1000) for patients aged 18-60, 23.4% (234/1000) for patients over 60; there were 692 cases of simplex hepatitis E (simplex infection), 308 cases of hepatitis E complicated with chronic liver disease (super infection), of which, complicated viral hepatitis B took up the majority. (2) Clinical features: In the early stage, patients had symptoms of fever, stuffy nose, sore throat; 784 (78.4%) patients had jaundice during illness; 527 (52.7%) patients had loss of appetite, nausea and other gastrointestinal symptoms; ALT, AST of patients with hepatitis E plus posthepatitic cirrhosis were significantly lower than patients with simplex infection (all P<0.01); total bilirubin in patients over 60 was significantly higher than that of young and middle-aged patients, statistical difference in statistical analysis was (P <0.05); in the study, 274(27.4%) patients had complications, complication probability of patients aged over 60 was higher than young and middle-aged patients, difference comparison was statistically significant (P<0.05); complication probability of super infected patients was higher than those with simplex infection (P<0.01). All the patients underwent liver protection, jaundice removal and other symptomatic treatments, achieving good treatment effect: 315 cases were cured, 678 cases had improved condition, 7 cases died. CONCLUSION: There exists obvious correlation between morbidity of sporadic viral hepatitis E and season, gender and age; once sicken, one needs to take early symptomatic treatment, to avoid more severe damage to liver function.
ABSTRACT
We explored the significance of the expression of hepatitis E virus (HEV) open reading frame 3 (ORF3) in hepatitis E rat models. We also investigated its diagnostic value. Forty Sprague-Dawley (SD) rats were infected with HEV and 10 uninfected rats were selected for the control group. Rats were sacrificed at 14, 21, 35 and 70 days after infection. They were divided into 4 groups: Model group 1, model group 2, model group 3 and model group 4. ORF3 protein expression level in liver tissue, level of adipokines [fatty acid synthase (FAS), tissue inhibitor of metalloproteinase-2 (TIMP-2) and angiotensin-converting enzyme inhibitor 2 (ACE-2)], Th1/Th2 cells balance [interferon (IFN), interleukin-4 (IL-4) and Th1/Th2] and the level of immune outcome (levels of CD4+, CD8+ T lymphocytes and CD4+/CD8+) were measured and compared among groups. Our results showed that HEV IgG and HEV RNA levels in the model group 3 were higher than those in the other 3 groups. Compared with the control group, expression level of ORF3 protein in the liver tissue as well as Fas and TIMP levels were significantly higher in the model group 3. ACE-2 level was significantly lower than that of the control group (P<0.05). In the model group 3, IFN-γ, IL-4 and Th1/Th2 levels were meaningfully higher than those of the control group. CD4+ T lymphocytes and CD4+/CD8+ ratio were obviously lower than those in the control group (P<0.05). The expression level of ORF3 was positively correlated with levels of Fas, TIMP-2 and Th1/Th2. It was negatively correlated with ACE-2 and CD4+/CD8+ levels (P<0.05). We concluded that ORF3 expression level was directly related to severity and prognosis, and that ORF3 protein can be considered as a sensitive and specific diagnostic index.