A Risk Prediction Model Construction Based on Laboratory Indicators for Severe Hepatitis Progression in Chronic Liver Insufficiency Patients with HEV Infection

GUO Jun; MA Jianwei; HE Xiqi; LIU Peng

doi:10.3639/j.issn.2095-3097.2026.01.022

Abstract：Objective To investigate the risk factors for severe progression in patients with chronic liver insufficiency with hepatitis E virus(HEV)infection and to construct a risk prediction model based on laboratory indicators.Methods A total of 177 patients with chronic liver insufficiency and HEV infection who were diagnosed and treated at Linfen Central Hospital from January 2016 to January 2024 were retrospectively enrolled.They were divided into groups based on whether they progressed to severe hepatitis(severe group:107 patients;non-severe group:70 patients).Univariate and multivariate Logistic regression analyses were used to screen for risk factors associated with severe progression in these patients,and a nomogram prediction model was constructed.The predictive performance of the model was evaluated.Results Among the 177 patients included in this study,107 experienced severe progression,with an incidence of 60.45%.Univariate analysis showed that total bile acid(TBA)level,high-density lipoprotein cholesterol(HDL-C)level,apolipoprotein A1 level,and blood uric acid level were associated with severe progression in patients with chronic liver insufficiency and HEV infection(P<0.05).Multivariate Logistic regression analysis revealed that TBA level and blood uric acid level were independent risk factors for severe progression(P<0.05),while HDL-C level and apolipoprotein A1 level were independent protective factors(P<0.05).The predictive performance of the four independent influencing factors(TBA,HDL-C,apolipoprotein A1,and blood uric acid)and the nomogram model probability for severe progression in these patients was analyzed.The results showed that the areas under the receiver operating characteristic curve were 0.743,0.725,0.729,0.713,and 0.887,the area under the curve predicted by the nomogram model was higher than that predicted by any single indicator(P<0.05).Conclusion The risk of severe progression in patients with chronic liver insufficiency and HEV infection is closely related to laboratory indicators such as TBA,HDL-C,apolipoprotein A1,and blood uric acid levels.The nomogram model constructed using these four factors demonstrates good predictive performance for severe progression in these patients.