Sistematski pregled globalne epidemiologije virusno izazvanog akutnog zatajenja jetre.
BMJ open
Sažetak istraživanja
Ciljevi Etiologija i teret virusno induciranog akutnog zatajenja jetre ostaje nejasan u cijelom svijetu. Važno je razumjeti epidemiologiju virusno izazvane ALF za planiranje kliničkog upravljanja slučajevima i prevencije slučajeva. Učesnici Ovaj sistematski pregled je sproveden kako bi se sintetizovali podaci o relativnom doprinosu različitih virusa etiologiji virusno izazvanog akutnog zatajenja jetre u pokušaju da se sakupe dokazi koji trenutno nedostaju u ovoj oblasti. EBSCOhost, PubMed, ScienceDirect, Scopus i Web of Science pretraživali su relevantnu literaturu objavljenu od 2009. do 2019. Prvobitna pretraga je obavljena 9. aprila 2019. i ažurirana putem PubMed-a 30. septembra 2019. bez uključivanja novih kvalifikovanih studija. Dvadeset pet prihvatljivih studija uključeno je u rezultate ovog pregleda.
Rezultati Ovaj sistematski pregled procijenio je teret akutnog zatajenja jetre nakon infekcije virusom hepatitisa B, virusom hepatitisa A, virusom hepatitisa C, virusom hepatitisa E, virusom herpes simpleksa/humanim herpesvirusom, citomegalovirusom, Epstein-Barr virusom i parvovirusom B19. Podaci su uglavnom nedostajali za akutno zatajenje jetre nakon infekcije varičela-zostervirusom, humanim virusima parainfluence, virusom žute groznice, coxsackie virusom i/ili adenovirusom. Prevalencija akutnog zatajenja jetre izazvanog hepatitisom A bila je značajno niža u zemljama s rutinskom imunizacijom protiv hepatitisa A u odnosu na ne rutinsku imunizaciju protiv hepatitisa A. Virus hepatitisa E bio je najčešći etiološki uzrok virusno induciranog akutnog zatajenja jetre koji je opisan u ovom pregledu. Osim toga, virusno indukovano akutno zatajenje jetre imalo je loše ishode na što ukazuju visoke stope smrtnosti, koje izgleda rastu s lošim ekonomskim statusom proučavanih zemalja.
Zaključci Imunizacija protiv hepatitisa A i hepatitisa B treba imati prioritet u zemljama sa niskim i srednjim dohotkom kako bi se spriječile visoke stope smrtnosti od akutnog zatajenja jetre uzrokovane virusom, posebno u okruženjima gdje nedostaju resursi za upravljanje akutnim zatajenjem jetre. Treba istražiti proširenu upotrebu imunizacije protiv hepatitisa E jer je virus hepatitisa E bio najčešći uzrok akutnog zatajenja jetre. Registracija PROSPERO registarski broj: CRD42017079730.
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Systematic review of the global epidemiology of viral-induced acute liver failure.
Objectives The aetiology and burden of viral-induced acute liver failure remains unclear globally. It is important to understand the epidemiology of viral-induced ALF to plan for clinical case management and case prevention. Participants This systematic review was conducted to synthesize data on the relative contribution of different viruses to the aetiology of viral-induced acute liver failure in an attempt to compile evidence that is currently missing in the field. EBSCOhost, PubMed, ScienceDirect, Scopus and Web of Science were searched for relevant literature published from 2009 to 2019. The initial search was run on 9 April 2019 and updated via PubMed on 30 September 2019 with no new eligible studies to include. Twenty-five eligible studies were included in the results of this review.
Results This systematic review estimated the burden of acute liver failure after infection with hepatitis B virus, hepatitis A virus, hepatitis C virus, hepatitis E virus, herpes simplex virus/human herpesvirus, cytomegalovirus, Epstein-Barr virus and parvovirus B19. Data were largely missing for acute liver failure after infection with varicella-zostervirus, human parainfluenza viruses, yellow fever virus, coxsackievirus and/or adenovirus. The prevalence of hepatitis A-induced acute liver failur was markedly lower in countries with routine hepatitis A immunisation versus no routine hepatitis A immunisation. Hepatitis E virus was the most common aetiological cause of viral-induced acute liver failure reported in this review. In addition, viral-induced acute liver failure had poor outcomes as indicated by high fatality rates, which appear to increase with poor economic status of the studied countries.
Conclusions Immunisation against hepatitis A and hepatitis B should be prioritised in low-income and middle-income countries to prevent high viral-induced acute liver failure mortality rates, especially in settings where resources for managing acute liver failure are lacking. The expanded use of hepatitis E immunisation should be explored as hepatitis E virus was the most common cause of acute liver failure. Registration PROSPERO registration number: CRD42017079730.
Izvorni podaci
- DOI
- 10.1136/bmjopen-2020-037473
- PMID
- 32690747
- PMCID
- PMC7375632
- Provjereno
- 2026-07-26
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