Clinical characteristics and factors influencing 6-month prognosis of 150 patients with hepatitis-associated aplastic anemia

Abstract

Abstract: Objective In order to investigate the clinical characteristics of 150 cases of hepatitis-associated aplastic anemia (HAAA) and the factors influencing 6-month prognosis of them. Methods Retrospective analysis was carried out in 150 patients with HAAA admitted to our hospital from November 2016 to November 2018. All patients were treated with supportive and immunosuppressive therapy. The clinical features and efficacy of 6-month treatment were observed. Multivariate logistic regression analysis was used to analyze the independent factors influencing HAAA patients′ outcomes after 6 months of treatment. Results Among 150 HAAA patients, 80.00% were males, 90.00% were younger than 25 years old. The onset internal from hepatitis to aplastic anemia (AA) was (42.50 ± 10.35) days, the interval between the onset and treatment of AA was (17.72 ± 4.10) days, and 78.00% of AA occurred during or after the recovery stage of hepatitis. Among these patients, 5.33% were diagnosed as hepatitis A, 7.33% as hepatitis B, 2.00% as hepatitis C, 5.33% as hepatitis E, and 80.00% as unidentified hepatitis. As for AA, 48.00% were diagnosed as severe AA (SAA), 38.67% as very severe AA (VSAA), and 13.33% as non-severe AA. Within 3 months of AA, 70.00% patients showed clinical symptoms of infection. The effective rate of 150 HAAA patients receiving 6-month supportive and immunosuppressive therapy was 56.67%, of which partial response accounted for 33.33%, and complete response 23.33%. Multivariate logistic regression analysis showed that gender, severity of AA, serum total bilirubin (TBil) level during hepatitis, and the proportion of mature monocytes in bone marrow were independent factors influencing the prognosis of HAAA patients after 6 months of treatment (P<0.05). Conclusion HAAA mostly occurs in young male patients, with unidentified hepatitis, mainly manifested as SAA and VSAA. The risk of early infection in HAAA is high. The prognosis is poor, which is related to gender, severity of AA, serum TBIL level in hepatitis, and the proportion of mature monocytes in bone marrow.

Key words: Hepatitis-associated aplastic anemia, Hepatitis, Aplastic anemia, Immunosuppression

YU Xuan, LI Wen-hua, AN Dong-ying, WANG Yi-fan. Clinical characteristics and factors influencing 6-month prognosis of 150 patients with hepatitis-associated aplastic anemia[J]. Chinese Hepatolgy, 2020, 25(1): 24-27.

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