Jian Wu1, Xueyan Zhang2, Hongyang Liu3, Naizhou Guo4, Qiuwei Pan3, Yijin Wang5. 1. Department of Laboratory Medicine, The First People's Hospital of Yancheng City, Yancheng 224005, Jiangsu, China; Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, 3015CE, the Netherlands. 2. Department of Public Health, Jiangsu Vocational College of Medicine, Yancheng 224006, Jiangsu, China. 3. Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, 3015CE, the Netherlands. 4. Department of Laboratory Medicine, The First People's Hospital of Yancheng City, Yancheng 224005, Jiangsu, China. 5. Department of Pathology and Hepatology, Beijing 302 Hospital, Beijing, China. Electronic address: yijinwang927015@163.com.
Abstract
BACKGROUND & AIMS: Hepatitis E virus (HEV) infection contributes to substantial proportion of acute liver injury. This study aims to evaluate the ability of red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR) and RDW to lymphocyte ratio (RLR) in predicating the development of liver failure following HEV infection and the prognosis. METHODS: 93 healthy controls, 152 current/recent HEV infected patients without liver failure (HEV-non-LF) and 62 HEV patients who developed liver failure (HEV-LF) were enrolled in the study. The clinical and laboratory characteristics on admission, including RDW, neutrophil, lymphocyte, were recorded. Additional 24 HEV-LF patients and 24 HEV-non-LF patients were enrolled to validate the diagnostic efficacy of the three parameters. RESULTS: RDW, NLR and RLR were higher in HEV patients developing liver failure, compared with HEV-non-LF patients. Positive associations of increased RDW, RLR, NLR and incidence of liver failure were found. The AUC of RLR for predicting HEV-related liver failure was 0.74, superior to NLR and RDW. The sensitivity and specificity of RLR for predicting HEV-related liver failure were 0.74 and 0.65 respectively, superior to NLR (0.66, 0.70) and RDW (0.58, 0.67). However, no correlation between any of the three parameters and prognosis of HEV-LF was found. In addition, the three parameters were correlated with ALB, TBIL and Child-Pugh score in HEV-non-LF subjects, other than in HEV-LF patients. CONCLUSION: RDW, NLR and RLR are capable to predicate the development of liver failure in HEV patients, among which RLR showed the best sensitivity and specificity. These routinely available parameters shall be considered as new preliminarily diagnostic markers for fulminant hepatic damage in HEV patients.
BACKGROUND & AIMS:Hepatitis E virus (HEV) infection contributes to substantial proportion of acute liver injury. This study aims to evaluate the ability of red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR) and RDW to lymphocyte ratio (RLR) in predicating the development of liver failure following HEVinfection and the prognosis. METHODS: 93 healthy controls, 152 current/recent HEVinfectedpatients without liver failure (HEV-non-LF) and 62 HEVpatients who developed liver failure (HEV-LF) were enrolled in the study. The clinical and laboratory characteristics on admission, including RDW, neutrophil, lymphocyte, were recorded. Additional 24 HEV-LF patients and 24 HEV-non-LF patients were enrolled to validate the diagnostic efficacy of the three parameters. RESULTS: RDW, NLR and RLR were higher in HEVpatients developing liver failure, compared with HEV-non-LF patients. Positive associations of increased RDW, RLR, NLR and incidence of liver failure were found. The AUC of RLR for predicting HEV-related liver failure was 0.74, superior to NLR and RDW. The sensitivity and specificity of RLR for predicting HEV-related liver failure were 0.74 and 0.65 respectively, superior to NLR (0.66, 0.70) and RDW (0.58, 0.67). However, no correlation between any of the three parameters and prognosis of HEV-LF was found. In addition, the three parameters were correlated with ALB, TBIL and Child-Pugh score in HEV-non-LF subjects, other than in HEV-LF patients. CONCLUSION: RDW, NLR and RLR are capable to predicate the development of liver failure in HEVpatients, among which RLR showed the best sensitivity and specificity. These routinely available parameters shall be considered as new preliminarily diagnostic markers for fulminant hepatic damage in HEVpatients.
Authors: Thomas Theo Brehm; Omid Mazaheri; Thomas Horvatits; Marc Lütgehetmann; Julian Schulze Zur Wiesch; Ansgar W Lohse; Susanne Polywka; Sven Pischke Journal: Pathogens Date: 2021-01-12