Hepatitis E virus re-infection accelerates hepatocellular carcinoma development and relapse in a patient with liver cirrhosis: A case report and review of literature

Table 1 Laboratory results of the patient from August 2016 to April 2018

Time of admission (d)	1st	2nd	3rd	4th	5th	6th	7th
Date of admission	2016-08-19	2017-06-20	2017-09-26	2017-11-20	2018-02-07	2018-02-23	2018-04-16
Diagnosis	Cirrhosis	HCC	HCC	HCC	HCC	HCC	HCC
Treatment	Splenectomy	TACE	RFA	Partial hepatectomy		MWA	TACE and MWA
HEV IgM	Negative	Positive	Positive		Positive		Positive
HEV IgG	Positive	Positive	Positive		Positive		Positive
GLU (mmol/L)	7.81	4.49	5.82	5.04	5.44	5.31	4.67
BUN (mmol/L)	13.1	3.1	3.54	4.35	4.3	4.2	3.7
CO2_CP (mmol/L)	23.7	21.2	22.3	24	25.4	25.9	23.5
UA (umol/L)	334	271	312	293	282	289	300
CREA (umol/L)	65.5	58.4	72.8	65.25	65.7	61.1	62
ALT (U/L)	27	24	40	45	20	20	43
GGT (U/L)	166	154	224	232	67	65	195
ALP (U/L)	59	121	119	132	114	104	151
ChE (U/L)	3405	3926	4545	4393	3834	3515	3966
TP (g/L)	56.5	63.2	63.8	63.8	67.6	63.2	70.7
ALB (g/L)	27.2	29.3	30.8	31.3	30.6	29.2	32.5
TB (umol/L)	30.9	33.7	26.6	36.1	29.8	33.5	30.8
DB (umol/L)	8	7.7	5.4	7.7	7.7	7	7.8
TBA (umol/L)	2	27	46	22	76	41	32
Na (mmol/L)	141.6	141.2	140.7	141.9	139.3	141.4	139.9
K (mmol/L)	3.96	3.95	3.94	4.15	4.06	3.9	4.04
Cl (mmol/L)	109.6	109	107.1	108	109.9	109.3	107.7
Ca (mmol/L)	2	2	2.1	2.1	2.19	2.13	2.06
PHOS (mmol/L)	1.22	1.28	1.21	1.27	1.2	1.26	1.23
Mg (mmol/L)	0.81	0.7	0.81	0.82	0.83	0.81	0.84
AST (U/L)	38	39	49	67	38	37	55
CІV (ng/mL)	151.98					169.96	162.28
LN (ng/mL)	32.25					82.65	60.27
PШP (ng/mL)	10.9					17.33	15.82
HA (ng/mL)	841.13					592.83	553.67
HBsAg (E) (COI)	0.481	0.478			0.452	0.575	0.386
Anti-HBs (E) (IU/L)	494.2				309.7	308.1	353.5
HBeAg (E) (COI)	0.102				0.087	0.097	0.1
Anti-HBe (E) (COI)	1.27				1.12	1.15	1.23
Anti-HBc (E) (COI)	0.008				0.009	0.01	0.011
HBV-DNA (FQ-PCR) (IU/mL)	10				10	10	< 500
HAV IgM	Negative	Negative	Negative		Negative		Negative
Anti-HCV (COI)		0.03			0.04	0.04
HIV COM (COI)		0.21			0.22	0.24
Syphilis (COI)		0.08			0.07	0.08
AFP (A) (ng/mL)	4.12	3.6	4.57	8.59	2.7	3.79	3.58
CEA (A) (ng/ml)	4.74	4.86	4.32	5.47	4.71	5.89	5.65
PSA (A) (ng/mL)	0.1

HCC: Hepatocellular carcinoma; TACE: Transcatheter arterial chemoembolization; RFA: Radiofrequency ablation; MWA: Microwave ablation; HEV: Hepatitis E virus; IgM: Immunoglobulin M; IgG: Immunoglobulin G; GLU: Glucose; BUN: Blood urea nitrogen; CO2_CP: Carbon dioxide combining power; UA: Uric acid; CREA: Creatinine; ALT: Alanine aminotransferase; GGT: Gamma glutamyl transferase; ALP: Alkaline phosphatase; ChE: Cholinesterase; TP: Total protein; ALB: Albumin; TB: Total bilirubin; DB: Direct bilirubin; TBA: Total bile acids; AST: Aspartate aminotransferase; CIV: collagen IV; LN: Laminin; PШP: Precollagen type III peptidase; HA: Hyaluronate; HBsAg: Hepatitis B surface antigen; Anti-HBs: Hepatitis B surface antibody; HBeAg: Hepatitis B e Antigen; Anti-HBe: Hepatitis B e antibody; Anti-HBc: Hepatitis B core antibody; Anti-HCV: Hepatitis C virus antibody; HIV COM: Combination of HIV antibody; AFP: Alpha fetoprotein; CEA: Carcino-embryonic antigen; PSA: Prostate specific antigen; PHOS: Phosphorus; COI: Cut off index.