Prognostic Value of Apolipoprotein A-I in Acute Hepatitis E Virus (HEV) Infection: A Single-Center, Retrospective, Cohort Study From Shanghai, China.

Hepatitis E virus (HEV) is one of the most prevalent causes underlying acute hepatitis and jaundice worldwide. This study aimed to describe and analyze the correlations between serum lipids, apolipoproteins and outcomes of acute hepatitis E and to explore serum lipid metabolism markers for severe clinical phenotypes of HEV infection. A total of 496 adult HEV-infected patients were enrolled in this study, and their clinical and biochemical parameters were collected. The associations of serum lipids and apolipoproteins with the prognosis of the disease were described and compared. Additionally, the predictive value of apolipoprotein A-I (apoA-I) for the risks of severe jaundice, liver failure and mortality was analyzed. ApoA-I showed a close association with the disease severity of acute hepatitis E, and the baseline apoA-I level could serve as a predictive index for severe jaundice, liver failure and mortality. Using the cutoff values of 0.675 g/L and 0.435 g/L, patients could be stratified into corresponding risk groups for severe jaundice and mortality, respectively. This study revealed that serum apoA-I level is a strong prognostic indicator for severe jaundice and mortality and it may serve as an effective biomarker for severe acute hepatitis E.