[Prolonged hepatitis A: three case reports]

In this report, three patients, admitted to Ankara University Faculty of Medicine, Ibni Sina Hospital, Clinical Bacteriology and Infectious Diseases Department, with the diagnosis of acute viral hepatitis A have been discussed because of their clinical and/or biochemical relapses. Following conservative treatment and bedrest, the liver transaminases decrease to nearly normal levels but a second peak was observed later in three of the cases. Other viral, metabolic and autoimmune factors which could lead to the increase of liver transaminases were ruled out. Anti-HAV IgM antibodies became negative in 2 to 4 months later, and liver enzymes returned to normal in 4 to 5 months after onset of their illnesses. As a result, it was concluded that conservative follow-up and therapy would be sufficient since the prognosis of A hepatitis is usually benign even if it relapsed.