Bibliographic Details
| Title: |
The predictive value of fibrosis profiles for hepatitis E virus-related liver failure among hospitalized patients with acute hepatitis E: a retrospective cohort study |
| Authors: |
Rui Dong, Lili Huang, Lin Chen, Hong Xue, Jianguo Shao, Chunyan Ye, Yonglin Yang, Ke Xu, Zhenghan Luo, Jie Wang |
| Source: |
BMC Infectious Diseases, Vol 25, Iss 1, Pp 1-11 (2025) |
| Publisher Information: |
BMC, 2025. |
| Publication Year: |
2025 |
| Collection: |
LCC:Infectious and parasitic diseases |
| Subject Terms: |
Chronic liver disease, Noninvasive, Association, Risk stratification, Nonlinear, Discrimination, Infectious and parasitic diseases, RC109-216 |
| More Details: |
Abstract Background Hepatitis E virus (HEV) infection is an important etiology of liver failure. This study aimed to explore the associations of blood fibrosis profiles with HEV-related liver failure (HEV-LF) onset and evaluate their prediction performance in hospitalized patients with acute hepatitis E. Methods Participants were obtained from two tertiary medical centers in Jiangsu, China, between January 2018 and November 2024. Cox proportional hazards regression, restricted cubic splines, and threshold effect analysis were used to examine associations between fibrosis markers and HEV-LF risk. The predictive value of these markers was evaluated for importance ranking, discrimination, calibration, and net benefit. Results Among 504 included participants, 59 developed HEV-LF during hospitalization. After adjusting for covariates, elevated baseline laminin (HR = 1.432, 95% CI: 1.080–1.900), fibrosis-4 score (HR = 1.865, 95% CI: 1.375–2.530), and aspartate aminotransferase to platelet ratio index (APRI) (HR = 1.603, 95% CI: 1.315–1.954) were associated with a higher HEV-LF risk in a dose-dependent manner. Hyaluronic acid (≤ 740 ng/mL: HR = 1.797, 95% CI: 1.177–2.744) and type IV collagen (≤ 137 ng/mL: HR = 3.075, 95% CI: 1.709–5.533) showed nonlinear associations. APRI was ranked the highest in importance, and its combination with the other two top important markers provided good discrimination (7-day HEV-LF: AUROC = 84.98%, 95% CI: 78.55–91.41; 14-day HEV-LF: AUROC = 80.11%, 95% CI: 73.49–86.73), calibration, and clinical utility for predicting HEV-LF onset. Conclusions Several blood fibrosis markers are closely associated with HEV-LF risk and have promising predictive value. These findings may inform clinical risk stratification in patients with AHE. Trial registration Not applicable. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1471-2334 |
| Relation: |
https://doaj.org/toc/1471-2334 |
| DOI: |
10.1186/s12879-025-10632-z |
| Access URL: |
https://doaj.org/article/c73c659da22047178d57acb0376ad260 |
| Accession Number: |
edsdoj.73c659da22047178d57acb0376ad260 |
| Database: |
Directory of Open Access Journals |
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