Comparative Analysis on Clinical Characteristics Among Patients with Acute Hepatitis A Virus (HAV) and Patients with Acute Hepatitis E Virus (HEV): A Single-Center Retrospective Study from Bulgaria

Abstract

Introduction

The acute viral hepatitis was one of the most common conditions in daily clinical practice varying in different parts of the world. The aim of the present study was to perform a comparative analysis on clinical characteristics among patients with acute hepatitis A virus (HAV) infection and patients with acute hepatitis E virus (HEV) infection admitted to the Military Medical Academy (MMA), Sofia, Bulgaria.

Methods

A retrospective study was performed at MMA, between 1 January 2016 and 31 December 2021. The etiological diagnosis was confirmed by enzyme-linked immunosorbent assay (ELISA) HAV/HEV IgM serology assays.

Results

The current survey included 231 patients with mean age 45.11 ± 16.08 years (95% confidence interval: 43.04–47.19). According to the case definition, inclusion and exclusion criteria, persons were divided into two groups: patients with acute HAV infection (68.4%; 158/231) and patients with acute HEV infection (31.6%; 73/231). Males with HEV had 3.091 times the odds of comorbidity “hypertension” than males with HAV (p = 0.032). There were almost equal odds of increased ALT (odds ratio = 0.999; p = 0.003) in men with HEV and men with HAV. Females with HEV had 5.161 times the odds of comorbidity “hypertension” compared with females with HAV (p = 0.049). We found almost equal odds for elevated ALT in women with HEV and women with HAV (OR = 0.999; p = 0.025). In the non-elderly group (<60-year-old), HEV individuals had 4.544 and 10.560 times the odds of comorbidities “hypertension” and “cardiovascular diseases” compared with HAV patients (p < 0.05). We found almost equal odds for elevated ALT in HEV patients and HAV participants (OR = 0.998; p = 0.002).

Conclusion

The results from the current study may support the physicians daily care for patients with acute HAV and acute HEV.

Keywords:

• Bulgaria
• clinical characteristics
• hepatitis A virus
• HAV
• hepatitis E virus
• HEV
• single-center study

Ethical Approval

This study was conducted in accordance with the Military Medical Academy, Sofia, Bulgaria research ethical guidelines and according to ethical principles included in the Declaration of Helsinki (adopted in June 1964, last revision in October 2013). Ethical approval for this survey was obtained from the Local Ethics Committee of Military Medical Academy, 1606 Sofia, Bulgaria (MMA, 02/2022).

Acknowledgments

We are grateful to all physicians, nurses, laboratory staff, and patients who participated in the study. We thank the staff of the Military Medical Academy, Sofia, Bulgaria, for the medical care and treatment of the patients. In addition, we thank our families for providing us with the time and support needed to write this survey in a timely manner.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare no conflicts of interest.

Additional information

Funding

The Article Publishing Charge (APC) was funded by a scientific project “Development of Research and Innovation at Trakia University in Service of Health and Sustainable Well-Being”, Funding organization – Bulgarian Ministry of Education and Science (Grant number: BG-RRP-2.004-0006). The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.