Chronic hepatitis B virus infection is an independent risk factor for liver-related mortality in people with acute hepatitis E virus infection, according to researchers.

Hepatitis E (HEV) is also associated with a higher mortality rate than acute hepatitis A (HAV), they wrote in Clinical Infectious Diseases.

Although HAV incidence has declined over the past 10 years, HEV has been on the rise and, according to WHO, caused an estimated 44,000 deaths in 2015 alone. Both diseases are global health problems, especially in poorer countries, the researchers said, but complete data on their outcomes are lacking.

The study’s cohort included 1,068 patients with acute HAV and 846 with acute HEV. Eighty-five patients with HAV (8%) and 114 with HEV (13.5%) also had HBV, the researchers said.

At 30 days after diagnosis, the all-cause mortality rate among patients with HEV was 3.9%, compared with 0.6% among those with HAV. Liver-related mortality rates were 2% and 0.3%, respectively, and the hepatic event rates were 2.8% and 0.3%, respectively.

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