CLINICAL AND LABORATORY CHARACTERISTICS OF THE COURSE OF HEPATITIS E IN HOSPITALIZED PATIENTS

Abstract

Background. Hepatitis E virus (HEV) remains a significant concern for the public health system of the Republic of Belarus due to the widespread circulation of zoonotic genotype 3 among the population and animals. Objective. To evaluate clinical and laboratory features and identify prognostic markers of the course of acute hepatitis E in hospitalized adult patients in Minsk. Material and methods. We conducted a retrospective analysis of 51 medical records of patients with a verified diagnosis of acute hepatitis E (IgM anti-HEV (+) and/or PCR (+)) treated in infectious disease hospitals in Minsk between 2016 and 2026. Clinical presentation, severity, length of stay, as well as biochemical parameters (alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, alkaline phosphatase (ALP), gammaglutamyl transpeptidase (GGT), lactate dehydrogenase (LDH), ferritin, C-reactive protein (CRP), urea, creatinine) were assessed. Statistical processing was performed using nonparametric methods (Mann–Whitney U test, Kruskal–Wallis H test, Spearman's rank correlation coefficient). Differences were considered statistically significant at p<0.05. Results. The icteric form was diagnosed in 78.4% (n=40) of patients and was characterized by significantly higher levels of ALT (p=0.002), AST (p=0.001), bilirubin (p<0.001), ALP (p=0.008), and GGT (p=0.003). Disease severity correlated most strongly with total bilirubin (ρ=0.63; p<0.001) and AST (ρ=0.51; p<0.001) levels. Length of stay depended on bilirubin (ρ=0.45; p=0.002) and urea levels (ρ=0.51; p=0.003). Ferritin levels were significantly higher in patients with a severe form of the disease (ρ=0.60; p=0.02). Conclusion. Hepatitis E in Minsk is characterized by a predominance of icteric forms with a pronounced cholestatic component. Total bilirubin and urea levels can be considered feasible prognostic markers for length of stay.