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[Acute viral hepatitis A and C: report of a case]
M González Murillo1, J C Erdozain Sosa, J A Rodríguez Blanes
1Servicio de Aparato Digestivo, Hospital La Paz, Madrid.
Insights
Simultaneous infection with hepatitis A and C viruses can cause prolonged elevated liver enzymes. Persistent hepatitis A symptoms warrant further testing for co-infection with hepatitis C virus.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis A virus (HAV) and hepatitis C virus (HCV) are common causes of liver inflammation.
- Coinfections can present complex clinical pictures and diagnostic challenges.
Observation:
- A patient presented with acute hepatitis, initially showing IgM antibodies to HAV.
- Initial serological tests for hepatitis B, C, cytomegalovirus, and Epstein-Barr virus were negative.
- Elevated transaminases persisted for over 9 months.
Findings:
- Repeat serology confirmed positive hepatitis C antibody, while hepatitis B remained negative.
- The prolonged illness and elevated transaminases indicated a potential coinfection.
- This case highlights a simultaneous acute hepatitis A and C virus infection.
Implications:
- Persistent hepatitis A infection necessitates comprehensive serological evaluation for other viral cofactors.
- Early and accurate diagnosis of viral hepatitis coinfections is crucial for effective management.
- This case underscores the importance of re-evaluating serological markers in prolonged hepatitis cases.
Abstract:
We present a case of acute hepatitis by simultaneous A and C virus infection. The coinfection was suspected due to the high levels of transaminases lasting more than 9 months after onset of the illness. During the early stages of the illness, the patient had IgM antibodies to hepatitis A virus. Serological tests for hepatitis B and C viruses, cytomegalovirus and Epstein-Bar virus were negative. Due to the persistently high transaminase levels, we repeated the serology, detecting positive results for hepatitis C antibody, while hepatitis B serology remained negative as well that for all other virus tested. With these findings, we believe that a patient with hepatitis A of long duration, requires additional serological examinations to determine the possibility of coinfection by another virus.