Indian Journal of Health Sciences and Care

  • Year: 2018
  • Volume: 5
  • Issue: 3

Influenza A/H1N1pdm 09 Infection in Liver Disease Patients Requiring ICU Care

  • Author:
  • Vijeta Bajpai1, Ekta Gupta2,, Naveen Kundu3, Sachin Kumar4, Rakhi Maiwal5
  • Total Page Count: 5
  • Page Number: 109 to 113

1Senior Resident, Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi-110070, India

2Additional Professor, Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi-110070, India

3Senior Resident, Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi-110070, India

4Department of Pulmonology, Institute of Liver and Biliary Sciences, New Delhi-110070, India

5Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi-110070, India

*Corresponding author email id: ektagaurisha@gmail.com

Online published on 9 April, 2019.

Abstract

Influenza A/H1N1pdm 09 (H1N1) virus is more pathogenic than seasonal influenza and known to be more severe in patients with underlying chronic diseases. However, limited data is available regarding H1N1 infection in Chronic-Liver-Disease (CLD) patients.

Consecutive CLD patients admitted in the hospital over a period of 3 months with symptoms of Lower-Respiratory-Tract-Infection (LRTI) were included. Throat-swab/Bronchoalveolar-lavage were collected in viral-transport-medium and laboratory diagnosis of H1N1 virus was made by real-time-reverse-transcriptasepolymerase-chain-reaction. Various clinical and laboratory parameters were recorded and compared between patients with confirmed H1N1 infection and without H1N1 infection.

A total of 87 CLD patients with median CTP (Child-Turcotte-Pugh & MELD (Model-for-End-Stage-Liver-Disease) score; 12 (8–15), 31 (14–40) respectively with symptoms of LRTI were included. The mean age of the patient was 47.95 (± 12.09) years with male: female ratio was 8: 1. Over-all confirmed H1N1 infection was present in 15 (17.2%) patients. Of them 8 (53.3%) patients required ICU care. There was significant deterioration of TLC, AST, ALT, urea and creatinine in H1N1 positive patients in ICU. (p=0.018, 0.04, 0.02, 0.004 and 0.02) respectively. Overall mortality was significantly higher in H1N1 positive patients when compared to H1N1 negative patients in ICU [7(87.5%), 0 (p<0.001)]. H1N1 infected patients in ICU were mostly on mechanical ventilation and showed lower oxygen saturation (p=0.017, 0.083) respectively when compared to patients without H1N1 infection.

H1N1 infection leads rapid deterioration of liver function and associated with poor clinical outcome in CLD patients admitted in ICU.

Keywords

H1N1 infection, Intensive care unit, Liver disease, Poor outcome