| Objectives: Through the collection of case file information from a medical center,we hope to understand the diagnosis and treatment status of hospitalized patients with viral hepatitis,especially chronic hepatitis B and hepatitis C,and provide reference data for continuous improvement and standardization of the prevention and treatment of chronic hepatitis B and C.Methods: In this survey,a total of 3912 inpatients with viral hepatitis diagnosed as the top three in the discharge diagnosis of a general hospital from January 2001 to December 2021 were collected.A retrospective epidemiological survey was conducted to understand the basic situation,clinical manifestations,clinical diagnosis,laboratory tests,and antiviral treatment of the patients based on the inpatient medical records,To analyze the clinical epidemiological characteristics and diagnosis and treatment status of hospitalized patients with viral hepatitis in this hospital.Results:1.Among the 3912 hospitalized patients with viral hepatitis,the proportion of HBV was 77.51%,and the proportion of HCV was 6.47%;The proportion of hepatitis A is 0.92%,the proportion of hepatitis E is 2.09,the proportion of hepatitis B overlapping type C is 0.23%,the proportion of hepatitis B overlapping type A infection is 0.18%,the proportion of hepatitis B overlapping type E infection is 0.18%,the proportion of EB virus infection is 0.43%,the proportion of CMV infection is0.26%,and the proportion of unknown causes is 11.73%.2 The proportion of hospitalized patients with viral hepatitis who are at or above the age of 50 to 60 years old is 26.42%,the proportion of diagnosed patients who are at or above the age of 40 to 50 years old is 22.86%,the proportion of agricultural workers is 33.95%,the proportion of male patients is 66.96%,the proportion of female patients is 33.04%,the ratio of male to female patients is 2.03:1,and the proportion of clinically diagnosed liver cirrhosis is 30.39%,The proportion of hospital deaths related to cirrhosis and HCC(Hepatocellular carcinoma,HCC)accounted for 92.91%.3 The average age of hepatitis B patients was 50.65 ± 14.59 years old,and the average age of diagnosis was 44.04 ± 16.84 years old.The age at which hepatitis B was diagnosed accounted for the highest proportion in the age group greater than or equal to 40 and less than 50(21.93%),followed by the age group greater than or equal to 50 and less than 60(20.65%).The highest proportion of patients with age for medical consultation was in the age group between 50 and 60 years old(26.75%),followed by 22.92% in the age group between 40 and 50 years old.The proportion of patients with clinical diagnosis of liver cirrhosis was 30.51%.The degree of liver injury and severity in HBe Ag positive patients were heavier than those in HBe Ag negative patients,and the degree of liver injury and severity in HBV DNA positive patients were heavier than those in HBV DNA negative patients,Patients with high levels of HBV DNA have more severe liver damage and disease severity than patients with low levels of HBV DNA.4 The average age of hepatitis C patients was 50.33 ± 11.81 years old,and the average age of diagnosis was 48.08 ± 11.80 years old.The highest proportion of diagnosed hepatitis C patients was in the age group aged 40 to 50 years(39.13%),followed by the age group aged 50 to 60 years(24.11%).However,39.92% of patients with a diagnosis age greater than or equal to 40 but less than 50 years old were followed by 25.3% of patients with a diagnosis age greater than or equal to 50 but less than 60 years old,while 17.79% of patients with a diagnosis age greater than or equal to 30 but less than 40 years old were diagnosed and 11.86% of patients with a diagnosis age were diagnosed.The proportion of males is higher than that of females.The proportion of clinically diagnosed cirrhosis was 42.69%.5 Among 3032 patients with hepatitis B,2289(75.49%)patients tested hepatitis B serum antigen antibody and HBV-DNA quantitative after admission,6(0.20%)patients only tested HBV-DNA quantitative,and 737(24.31%)patients only tested hepatitis B serum antigen antibody.6 Among 3032 hospitalized patients with hepatitis B,1306(43.07%)received antiviral treatment,and 1726(56.93%)received no antiviral treatment.821 cases received initial antiviral treatment after admission,432 cases received standard antiviral treatment before admission,and 53 cases received non-standard use of antiviral drugs before admission.Of the 1726 non antiviral patients,538(31.18%)were positive for HBV DNA,529(30.64%)were negative for HBV DNA,and 659(38.18%)were not detected for HBV DNA.7 Of 253 hospitalized patients with hepatitis C,163(64.43%)did not receive antiviral treatment,and 90(35.57%)received antiviral treatment.Before 2017,it was mainly interferon therapy,and after 2017,it was DDAs therapy.The highest proportion of patients(55.6%)who used Solimbuvir/velpatavir were 50.Conclusions:1 In the past 20 years,chronic hepatitis B has remained the main cause of hospitalization for viral hepatitis,followed by chronic hepatitis C.Although there are cases of hepatitis A and hepatitis E,they are sometimes sporadic.Another 459 cases(11.73%)had unknown etiology,and the laboratory diagnostic capacity for pathogens needed to be strengthened.2 The age of seeking medical advice for chronic hepatitis B and hepatitis C lags behind the age of diagnosis,and the age of hepatitis B is 50.65 ± 14.59 years vs44.04 ± 16.84 years.Hepatitis C was 50.33 ± 11.81 years old vs.48.08 ± 11.80 years old.The proportion of hepatitis B B related cirrhosis diagnosed on admission was 30.51%,and that of hepatitis C related cirrhosis was 42.69%.The main causes of hospital death are liver cirrhosis and HCC.The risk of serious adverse outcomes such as cirrhosis due to untimely treatment should be taken seriously.3 The diagnostic and treatment standards for HBV and HCV infections need to be improved,especially due to insufficient understanding of the disease by non specialized physicians.737 hospitalized patients with hepatitis B were not tested for HBV DNA.1306 inpatients(43.07%)received antiviral treatment.The number of hospitalized patients who did not receive antiviral treatment reached 1726(56.93%),and there were still cases of using non first-line drugs for treatment.4 Of the 253 hospitalized patients with hepatitis C,163(64.43%)did not receive antiviral treatment,and 90(35.57%)received antiviral treatment.Before 2017,the main treatment regimen was interferon therapy,and in 2017,the direct antiviral drug(DDAs)treatment regimen began.The highest proportion of patients(55.6%)were treated with sofibuvir.5 Of the 121 cases of HBs Ag positive and anti HBs positive,HBV DNA was still detected in 33 cases,and HBV DNA was detected in 4 cases of HBs Ag negative and anti HBs positive,suggesting that even if protective antibodies against HBs were present,it is still possible that HBV has not been cleared.Patients with this condition should be concerned. |
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