| Objective To explore the clinical characteristics and prognosis of patients with HBV infection-related end-stage liver disease in EBV-DNA positive group and negative group,so as to provide a theoretical basis for clinical prevention and treatment.Methods The patients with end-stage liver disease who underwent EBV-DNA detection in the Department of Infection and Diseases,General Hospital of Ning Xia Medical University from January 2015 to June 2020 were retrospectively analyzed.The clinical data were recorded in detail.According to the results of serum patients were divided into EBV-DNA positive group and EBV-DNA negative group.The general information(age,gender,etc.),laboratory examination(blood routine,liver function,HBV-DNA,HBe Ag,EBV-antibody four tests,etc.),Child classification,and Meld score of the two groups were compared.The survival status of the patients was followed up,and the survival time was recorded for prognosis analysis.Results Among 197 patients with end-stage liver disease,68 cases were tested for EBV-antibody,67 cases were positive,and the total positive rate was 98.5%.The positive rate of males was 100%(56/56),and that of females was 90.9%(10/11).There was no significant difference in the positive rate between males and females(P>0.05).Five antibody patterns were detected in 67patients,and the positive rates of EBVCA-IgG and EBNA-IgG were the highest,accounting for 82%.Among 197 patients with end-stage liver disease,63 cases were EBV-DNA positive group and 134 cases were EBV-DNA negative group.The positive rate of EBV-DNA was 32%,and the viral load range was 5.01*10~3–7.31*10~5IU/ml.There were significant differences in age,clinical symptoms(fever and fatigue),laboratory indexes(WBC,ALB,r GGT,HBV-DNA,HBe Ag)and Child classification between EBV-DNA positive group and EBV-DNA negative group(P<0.05).There was no significant difference in gender,clinical symptoms(abdominal distension,yellow skin staining,splenomegaly),laboratory indexes(NEUT%,HGB,PLT,ALT,AST,TBIL,DBIL,IBIL,CR,PT,PTA,INR,PCT,Meld scores),and EBV-antibody between the two groups(P values>0.05).Comparing the clinical characteristics of the survival group and the death group of patients with end-stage liver disease,there were 122 people in the survival group and 75 people in the death group,The case fatality rate was(38.1%).The average age of the survival group was(50.19±12.65)years,and 31cases(25.4%)were 60 years or older.The average age of the death group was(55.48±11.59)years old,33 cases(44.0%)were≥60 years old,and the age,EBV-DNA,WBC,NEUT%,HGB,ALB,r GGT between the two groups were statistically significant(P<0.05).Multivariate logistic regression analysis was performed on the above-mentioned meaningful indicators,and the results showed that EBV-DNA positive is a risk factor for death in patients with end-stage liver disease(P value<0.05).The median death time of EBV-DNA negative group was 16months,and that of EBV-DNA positive group was 14 months.The survival time of EBV-DNA negative group was longer than that of EBV-DNA positive group,and the difference in the distribution of survival between the two groups was statistically significant(P<0.05).Conclusion 1.Patients HBV infection-related end-stage liver disease have poor prognosis with EBV-DNA positive.Positive EBV-DNA is a risk factor for death in patients with end-stage liver disease.2.Since the clinical symptoms of EBV infection are varied,and most of them are in the state of latent infection,four examinations of EBV-DNA and EBV-antibody should be performed simultaneously in the diagnosis. |
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