LAUSR

Development of biomarkers for predicting the occurrence of hepatitis E virus related‐acute liver failure (HEV‐ALF) is conducive to prevention and early intervention. Serum samples from 250 HEV‐ALF patients, 250 patients with acute hepatitis E (AHE) and 250 health controls (HCs) were collected. We assessed the predictive ability of extracellular vesicle (EV)‐derived argininosuccinate synthase 1 (ASS1) levels for HEV‐ALF occurrence. Serum EVs were successfully isolated. EV‐derived ASS1 levels in the HEV‐ALF patients were significantly higher than those in the AHE patients and HCs. In HEV‐ALF patients, EV‐derived ASS1 levels were positively correlated with the number of failed organs and disease progression. The logistical regression showed that EV‐derived ASS1 level is an independent risk factor for HEV‐ALF, and orthogonal partial least squares discriminant analysis (OPLS‐DA) also suggested that EV‐derived ASS1 level has high predictive capability. Besides, the area under the curve (AUC) of EV‐derived ASS1 level to predict HEV‐ALF occurrence was 0.728 (0.684–0.772) with the sensitivity and specificity being 72.80% and 64.80%, which had a high decision‐making ability. Furthermore, there existed no significant difference between the age ≥60 and age <60 groups in EV‐derived ASS1 levels. Serum EV‐derived ASS1 level is a promising predictor for the occurrence of HEV‐ALF.