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Cholestatic syndrome in viral hepatitis A
Andrey I Petrov1, Nikolay T Vatev, Maria V Atanasova
1Department of Lnfectious Diseases, Parasitology and Tropical Medicine, St. George University Hospital, Medical University, Plovdiv, Bulgaria. dr_andre_petrov@yahoo.com
Folia Medica
|August 23, 2012
Summary
Cholestatic viral hepatitis A, though rare, can present severely. This study highlights 17 cases, revealing significant cholestasis and prolonged illness in patients with hepatitis A virus infection.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Cholestatic forms of viral hepatitis A are uncommon but significant due to severe disease and high morbidity.
- Understanding these severe presentations is crucial for effective patient management.
Purpose of the Study:
- To investigate the characteristics and clinical course of cholestatic viral hepatitis A.
- To identify the prevalence and severity of cholestatic hepatitis A in a defined patient cohort.
Main Methods:
- Retrospective analysis of 17 patients with hepatitis A virus (HAV) infection and pronounced cholestasis.
- Data collected included age, bilirubin levels, liver enzymes (ALT, ALP, GGT), urine urobilinogen, hepatomegaly, and hospital stay.
- Diagnosis confirmed via anti-HAV/IgM testing in patients from a larger cohort of 820 viral hepatitis A cases.
Main Results:
- Cholestatic hepatitis A occurred in 2.07% (17/820) of patients.
- These 17 cases represented 14 with a cholestatic component and 3 as distinct cholestatic forms.
- Patients experienced prolonged hospital stays (mean 49.1 days), high bilirubin levels (>150 µmol/l for >1 month), and elevated transaminase activity (mean ALT 2011 U/l).
Conclusions:
- Viral hepatitis A with cholestatic syndrome affects approximately 2.07% of cases.
- A significant proportion (23.5%) of these cholestatic cases presented as severe forms of the disease.
- Severity is indicated by elevated transaminases, high bilirubin, and pronounced systemic symptoms like intoxication and vomiting.
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