Hepatitis E Virus Infection is Associated with Better Survival in Acute Liver Failure

Abstract

Background and Aims: Acute Liver Failure (ALF) is associated with a high mortality. The difference in outcomes between different etiologies is not clear. We analysed the outcomes of consecutive ALF patients admitted at a single tertiary-care centre over a period of 25 years. Methods: An analysis of the prospectively maintained database of ALF patients was performed to assess the effect of etiology on the outcome. Results: A total of 1347 patients were evaluated. Out of these 755 (56.1%) were females and 592 (43.9%) were males. The mean age ± SD was 28.4 ± 11.7 years. Hepatitis A (1.2%), acute Hepatitis B (7.6%), Hepatitis E (29.0%), Non -A, Non-E (38.3%), dual infection (4.9%) and anti-tubercular therapy (4.8%) comprised different etiologies of ALF. Among 10.2% of patients only chronic markers were positive and no etiological data was available in 4% of patients. A total of 797 (59.2%) patients died. The survival among different etiologies was HAV (62.5%), acute HBV (32%), HEV (53.6%), Non-A, Non-E (37.9%), dual infection (30.3%), ATT (32.3%) and 32.1% in those with chronic markers (P < 0.001). Conclusions: HEV is an important cause of ALF and, among the different viral etiologies it is associated with a better survival rate.