Acute liver failure- relationship of outcome to etiological factors (hbv versus hev)

Introduction - Being an acute life threatening condition, there is very limited data about acute liver failure (ALF) from India. No study showed head to head comparison of ALF due to HBV and HEV, two main etiological factors for ALF in India.
Aim -The aim was to study the relationship of outcome to etiological factors, HBV versus HEV in ALF patients.
Materials & Method - Forty five patients of ALF with confirmed etiology (either HBV or HEV) over last 4 years at SAIMS Hospital, Indore, were studied retrospectively for various clinical and laboratory features and overall clinical outcome.
Results - out of total 45 patients 18 (40%) were HBV positive while 27 (60%) were HEV positive. Sixteen (59%) were female while 11 (41%) were male patients. Hepatitis E virus positive patients (25.78 ± 7.51 years) were younger than HBV positive (32.67 ± 12.02 years; p = 0.001). Five of 18 HBV positive patients died compared to 14 of 27 in HEV positive group of which maximum mortality noted in 20 - 29 year age group. None of those died in HBV positive group was pregnant compared to 7 pregnant patients in HEV positive. Duration of HE amongst HBV positive patient who died (4.20 ± 2.78 days) was significantly higher from those who died with HEV positive serology (1.93 ± 0.99 days; p = 0.015).
Conclusion - There was a trend towards higher mortality in HEV related ALF patients compared to HBV related ALF however it did not reach statistical significance and pregnancy did not affected mortality significantly in either group.