Prevalence and Predictors for Respiratory Viral Infections among Liver Disease Patients

Jasmine Samal; Tushar Prabhakar; Manya Prasad; Nitiksha Rani; Bansidhar Tarai; Reshu Agarwal; Abhishek Padhi; Arvind Tomar; Rakhi Maiwall; Debajyoti Bhattacharyya; Manoj Kumar Sharma; Ekta Gupta

doi:10.5005/jp-journals-10018-1400

Prevalence and Predictors for Respiratory Viral Infections among Liver Disease Patients

Euroasian J Hepatogastroenterol. 2023 Jul-Dec;13(2):108-114. doi: 10.5005/jp-journals-10018-1400.

Authors

Affiliations

¹ Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, India.
² Department of Epidemiology and Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India.
³ Department of Microbiology and Infection Control Services, Max Super Speciality Hospital (A Unit of Devki Devi Foundation), Max Healthcare, New Delhi, India.
⁴ Department of Pulmonary Medicine, Institute of Liver and Biliary Sciences, New Delhi, India.
⁵ Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.

Abstract

Aim and background: Respiratory viral infections (RVIs) cause significant hospitalizations every year. Also, RVIs caused by either influenza or noninfluenza group of viruses can have adverse outcomes, especially among immunosuppressed patients. Regular and timely supervision is needed for accurate etiological identification, to prevent inappropriate use of antibiotics in patients with nonbacterial etiology. This study aimed to identify the spectrum of RVIs and clinical characteristics among liver disease patients with influenza-like illness (ILI).

Materials and methods: In this study, medical records of patients with ILI, whose requests for respiratory viral testing came from September 2016 to December 2022 were retrospectively reviewed. Respiratory viruses were identified using FilmArray 2.0 respiratory panel (BioFire Diagnostics, USA).

Results: Of the 1,577 liver disease patients with ILI, the overall prevalence of RVI was 28% (n = 449). Infection by noninfluenza viruses (NIVs) was detected in 329 patients (73%), higher than those infected with influenza viruses. In multivariable logistic regression analysis, female gender [odds ratio (OR): 2.5, 95% confidence interval (CI): 1.5-4.2], infection with influenza B (OR: 3.3, 95% CI: 1.09-9.9) and decompensated cirrhosis (OR: 3.9, 95% CI: 1.7-8.5) were independent risk factors for mortality. Regarding seasonality, influenza peaked in monsoons and winters, whereas NIVs circulated throughout the year.

Conclusion: Overall, this study adds new knowledge regarding the incidence of RVI and the distribution of respiratory viral etiologies among liver disease patients with ILI. The findings highlight that female gender, decompensated cirrhosis, and influenza B infection are independently associated with poor clinical outcomes. Early etiological identification of viral causes of ILI could aid in an enhanced understanding of the prevalence of ILI and the timely management of the patients.

Clinical significance: Respiratory viral infections can cause severe illness in individuals with underlying liver disease. Accurate diagnosis and risk stratification is crucial in mitigating the adverse health effects.

How to cite this article: Samal J, Prabhakar T, Prasad M, et al. Prevalence and Predictors for Respiratory Viral Infections among Liver Disease Patients. Euroasian J Hepato-Gastroenterol 2023;13(2):108-114.

Keywords: Cirrhosis; Gender; Influenza; Liver; Noninfluenza; Respiratory viral infection; Seasonality.