长期戊肝IgM抗体阳性患者临床基本特征

A Study of Basic Clinical Characteristics of Patients with Long-term HEV IgM Antibody Positive

目的总结长期戊肝IgM抗体阳性患者临床基本特征。方法回顾性分析2018年1月至2023年9月在首都医科大学附属北京佑安医院(一家以感染、传染及急、慢性相关性疾病群体为主要服务对象和重点学科的医院)进行戊肝抗体和/或戊肝核酸检测的患者,了解感染和/或肝病专科就诊人群戊肝感染率,HEV IgM阳性持续时间≥6个月戊肝患者与6个月内HEV IgM转阴的戊肝患者比较,分析前者临床基本特征。结果近6年(2018年1月至2023年9月)北京佑安医院HEV IgM、HEV IgG抗体检测的患者共有31912例患者,其中HEV IgM阳性率6.92%(2280/31912),HEV IgG阳性率为24.36%(7775/31912)。近6年HEV IgM阳性率差异有统计学意义(χ^(2)=114.723,P<0.001),但2018年、2019年和2023年3年比较差异无统计学意义,这3年HEV IgM阳性率平均为5.66%。根据戊肝抗体检测情况,将患者分成4组,IgM+IgG+组、IgM+IgG-组、IgM-IgG+组和IgM-IgG-组,4组戊肝核酸阳性率差异有统计学意义(χ^(2)=232.791,P<0.001),IgM+IgG+组和IgM+IgG-组核酸检测率较高,核酸阳性率较高。HEV IgM阳性持续时间≥6个月的戊肝患者与HEV IgM6个月内转阴的患者比较,前者首次就诊基线ALT、TBil和DBil都显著低于对照组(均P<0.05),而TP高于对照组(P<0.05)。结论近些年戊肝重点就诊科室就诊患者戊肝感染率比较稳定。长期HEV IgM持续阳性的戊肝患者临床基本特征为首次就诊基线ALT、TBil和DBil低于普通戊肝患者,而TP高于普通戊肝患者。

Objective To evaluate the basic clinical characteristics of patients with long-term IgM antibody positive.Methods We retrospectively analyzed patients who underwent hepatitis E antibody and/or nucleic acid testing from January,2018 to September,2023 at Beijing You’an Hospital affiliated with Capital Medical University(a hospital with infection,infection,and acute and chronic related diseases as the main service target and key disciplines).We conducted the analysis to better understand the incidence of hepatitis E infection in the population receiving specialized treatment for infection and/or liver disease.Clinical characteristics were compare between the group(A)whose HEV IgM positive duration was greater than 6 months and those(B)whose HEV IgM turned into negative within 6 months.Results In the past six years(from January 2018 to September 2023),there were a total of 31,912 patients who underwent IgM and IgG antibody testing for hepatitis E in Beijing You’an Hospital.The positive rate of HEV IgM was 6.92%(2280/31912)and the positive rate of HEV IgG was 24.36%(7775/31912).HEV IgM positivity rates of these years were statistically significant( χ^(2)=114.723,P<0.001).But there was no statistically significant difference among 2018,2019 and 2023,with an average HEV IgM positivity rate of 5.66%.According to the antibody test results,patients were divided into four groups:IgM+IgG+group,IgM+IgG-group,IgM-IgG+group,and IgM-IgG-group.The difference in the positive rate of hepatitis E nucleic acid among the four groups was statistically significant( χ^(2)=232.791,P<0.001).The IgM+IgG+group and IgM+IgG-group had higher nucleic acid detection rates and positive nucleic acid rates.When compared group A with group B,we found that the baseline ALT,TBil and DBil of the first visit in group A were significantly lower than group B(all P<0.05).TP was higher than group B(P<0.05).Conclusion In recent years,the infection rate of hepatitis E among patients in key departments of hepatitis E has been relatively stable.The basic clinical characteristics of hepatitis E patients with long-term persistent HEV IgM positive are featured with lower levels of ALT,TBil and DBil,while TP is higher than ordinary hepatitis E patients at the first visit.