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[Viral hepatitis A with prolonged course in adults]
C Altman1, C Molinié, S Soudière
1Service des Maladies du Foie et de l'Appareil Digestif, Hôpital Bicêtre, Le Kremlin Bicêtre.
Gastroenterologie Clinique Et Biologique
|February 1, 1996
Summary
Protracted hepatitis A virus infection involves relapses, even without symptoms. Hepatitis E virus antibodies were common but unlikely to cause prolonged hepatitis A, possibly due to past exposure.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Context:
- Hepatitis A virus (HAV) infection typically resolves within months.
- A subset of patients experience a protracted disease course, lasting over six months.
- Understanding the characteristics of prolonged HAV is crucial for patient management.
Purpose:
- To investigate the clinical and virological features of patients with protracted hepatitis A.
- To explore the potential role of hepatitis C virus (HCV) and hepatitis E virus (HEV) in prolonged HAV.
Summary:
- Twenty-seven patients with HAV and elevated alanine aminotransferase (ALT) for over six months were studied.
- All patients experienced biological relapses, defined by significant ALT fluctuations, with a median time to first relapse of 87 days.
- While HEV IgG antibodies were detected in a significant proportion of both protracted and acute HAV cases, HEV IgM was rare, suggesting HEV does not drive protracted HAV.
Impact:
- This study characterizes protracted hepatitis A, highlighting the role of relapses.
- Findings suggest that co-infection or a role for hepatitis E virus is unlikely in the protracted course of hepatitis A.
- The results provide insights into the natural history of prolonged HAV infections and inform differential diagnosis.