Biochemical Features of an Acute Viral Hepatitis A Outbreak

International Journal of Medical Laboratory Research , 2018

Aim: Acute viral hepatitis A (HAV) is a major problem in parts of the developing countries. HAV is transmitted enterically and its incidence is high in places where poor hygienic conditions prevail. Most studies in the past have been on liver the primary organ affected by HAV and reports on extrahepatic organs are lacking. The present study was carried out to ascertain the alterations on the haematological, hepatic and renal parameters. Material and Methods: This was a retrospective study and was conducted in a tertiary care hospital in India. Data was analysed in people who expressed known symptoms of HAV and established by Anti-HAV IgM antibody. A total of 22 paediatric and 109 adult people were included in the study and compared with healthy individuals who were tested negative for infectious and chronic diseases. Results: The results indicated that jaundice, vomiting and fever were the predominant clinical symptom seen in both children and adults. There was significant difference in the various haematological, hepatic and electrolyte endpoints (p < 0.05 to 0.0001), while there was no such difference in the renal function test parameters. Conclusion: The present study indicates that acute infection with HAV causes alterations in haematological, hepatic parameters and in the levels of electrolytes in the serum.

Canadian Journal of Infectious Diseases and Medical Microbiology

Hepatitis A virus (HAV) is one of the well-known viruses that cause hepatitis all around the globe. Although this illness has decreased in developed countries due to extensive immunization, numerous developing and under-developed countries are struggling with this virus. HAV infection can be spread by oral-fecal contact, and there are frequent epidemics through nutrition. Improvements in socioeconomic and sanitary circumstances have caused a shift in the disease’s prevalence worldwide. Younger children are usually asymptomatic, but as they become older, the infection symptoms begin to appear. Symptoms range from slight inflammation and jaundice to acute liver failure in older individuals. While an acute infection may be self-limiting, unrecognized persistent infections, and the misapplication of therapeutic methods based on clinical guidelines are linked to a higher incidence of cirrhosis, hepatocellular carcinoma, and mortality. Fortunately, most patients recover within two months ...

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2015

Viral hepatitis is one of the most important public health problems around the world. One of these viruses, HAV is a small, nonenveloped, positive-strand RNA virus with a highly stable icosahedral protein capsid [1]. This virus causes a self limited infection, Hepatitis A infection, with worldwide distribution. The infection is highly endemic in developing countries and most children acquire immunity through asymptomatic infection early in life [2]. In these regions, most of the children under six years of age either asymptomatically infected or develop a mild self-limiting illness [3]. The clinical presentation of HAV infection, gastrointestinal, flulike symptoms, and jaundice, in infected individuals is strongly age dependent [4,5]. HAV infection in young children is often an asymptomatic and in older children and adults is often a symptomatic disease leading to overt illness. About 0.1% to 0.5% of infected adults develop fulminant hepatic failure (FHF), fatal in half of these cases [5]. FHF may occur in persons with underlying chronic liver disease (CLD) [4-7].

KYAMC Journal, 2018

Background: Acute hepatitis is one of the more common causes of hepatitis A virus (HAV). Humans appear to be the only reservoir for this virus. Clinical manifestations, and natural history of hepatitis A virus. The relative frequency of hepatitis A virus in Western country.Objectives: Hepatitis A infection developing countries where sanitation is still a public health issue. In Kyrgyzstan, there is no epidemiological data on children for this infection.Materials & Methods: A community based cross sectional study was carried in occurs around the southern city of Osh (Osh region) state in Kyrgyzstan in one of the smaller country central Asia. Total 260 children aged 1-18 years. Blood samples were analysed for anti-HAV total antibody (IgM and IgG) using a ELISA.Results: One hundred and forty four subjects tested positive for anti-HAV total antibody giving a prevalence rate of 55.4%. The median age for those positive was 9 years and for those without evidence of HAV infection was 4 year...

2013

Infection with hepatitis A virus is still one of the most common causes of hepatitis worldwide. The clinical manifestation of acute hepatitis A (AHA) in adults can vary greatly, ranging from asymptomatic infection to severe and fulminant hepatitis. The aim of this study was to describe the demographic, clinical characteristics, laboratory features and hospital outcome of adult patients with AHA over a consecutive period of 4 years within an area from Eastern European country. Two hundred and two adult patients diagnosed with AHA were retrospective, observational and analytic analized over a period of 4 years. Based on prothrombin time less than 50, the study group was stratified in medium (79.2%) and severe forms (20.8%). The hemorrhagic cutaneous-mucous manifestations (6.93%) associated with the severe forms of AHA (OR =12.19, 95%CI-3.59-41.3, p =0.001). We found statistically significant differences for PT (p &lt;0.001), INR (p &lt;0.001), TQ (p &lt;0.001), ALAT (p &lt;0.001), ASA...

Liver International Official Journal of the International Association For the Study of the Liver, 2008

Background: Hepatitis A infection, a vaccine-preventable disease, is an important cause of fulminant hepatic failure (FHF) in children in Argentina. Universal vaccination in 1-year-old children was implemented in June 2005. The limited studies about the correlation between the characteristics of the hepatitis A virus (HAV) and FHF have been carried out in adults. Methods: Samples from 41 children with FHF were studied from September 2003 to January 2006 and HAV RNA was detected, sequenced and analysed in the 5 0 non-coding region and VP1/2A region. Results: Eighteen HAV strains were characterized and found to be different at the nucleotide level from the self-limited acute infection strains that have been circulating in Argentina with no temporal or geographical pattern. They did not form a genetic cluster, but some of them were identical in the largest fragment characterized and some of them seemed to be more closely related in time and/or geographically. Conclusion: Our results suggest that viral factors could be involved in the severity of the clinical presentation of HAV infection in children in Argentina.

Aim: This study was performed to compare the clinical, biochemical and etiological properties of acute viral hepatitis (AVH) and to compare clinical and laboratory parameters of faeco-orally transmitted hepatitis: hepatitis A+ hepatitis E (A+E) with hematologicaly transmitted hepatitis: Hepatitis B, C, D (B+C+D). Material and Methods: Biochemical and clinical data were collected from 40 patients with AVH. They were tested for hepatitis B surface antigen (HBsAg), IgM anti-Hepatitis A virus (Immunoglobulin M HAV), IgM anti-HBc (Immunoglobulin M hepatitis B core antigen), IgM anti-hepatitis D (Immunoglobulin M HDV), or IgM anti-hepatitis C (Immunoglobulin M HCV). Finally X 2 test was used to analysis of data. Results: Most patients were young adults and presented with jaundice and other constitutional features, although anicteric hepatitis was also seen. Hepatitis E was the most common AVH. Malaise, fever, icterus, vomiting and nausea were significantly more in Hepatitis A +E compared with Hepatitis B + C in acute course. Serum bilirubin both total and direct was significantly elevated in hepatitis A + E compared with Hepatitis B + C in acute course. Conclusions: Hepatitis E was the most common AVH .There were some differences in clinical and laboratory findings regarding to the etiology but it does not necessarily distinguish one cause of hepatitis from another.

Liver International, 2007

Background: Hepatitis A infection, a vaccine-preventable disease, is an important cause of fulminant hepatic failure (FHF) in children in Argentina. Universal vaccination in 1-year-old children was implemented in June 2005. The limited studies about the correlation between the characteristics of the hepatitis A virus (HAV) and FHF have been carried out in adults.Methods: Samples from 41 children with FHF were studied from September 2003 to January 2006 and HAV RNA was detected, sequenced and analysed in the 5′ non-coding region and VP1/2A region.Results: Eighteen HAV strains were characterized and found to be different at the nucleotide level from the self-limited acute infection strains that have been circulating in Argentina with no temporal or geographical pattern. They did not form a genetic cluster, but some of them were identical in the largest fragment characterized and some of them seemed to be more closely related in time and/or geographically.Conclusion: Our results suggest that viral factors could be involved in the severity of the clinical presentation of HAV infection in children in Argentina.

Viral Hepatit Dergisi, 2014

Objectives: Hepatitis A is the most common type viral hepatitis in the world. We aimed to detect the incidence of acute hepatitis A (HAV) infection in Kırıkkale province in Turkey, which is placed among the developing countries. Materials and Methods: IgM Anti-HAV test were studied in serum samples collected from 4.088 children aged 0-18 years, who received a pre-diagnosis of acute hepatitis between January 2006 and December 2013. The cases were divided into the three age groups as 0-5, 6-11, and 12-18 years. Results: Out of 4.088 serologic examination samples, 299 (7.31%) were found to be positive for IgM anti-HAV. Seropositivity rate among the age groups were as follows: 7.69% in the 0-5 age group, 39.80% in the 6-11 age group, and 52.51% in the12-18 age group. Conclusion: Hepatitis A appears to predominantly infect adolescents and young adults in our country as in countries of intermediate hepatitis A endemicity. These kinds of studies will create a data source for studies evaluating vaccine efficacy throughout our country.

Virology Journal, 2011

Background: Hepatitis A virus is an infection of liver; it is hyperendemic in vast areas of the world including India. In most cases it causes an acute self limited illness but rarely fulminant. There is growing concern about change in pattern from asymptomatic childhood infection to an increased incidence of symptomatic disease in the adult population. Objective: In-depth analysis of immunological, viral quantification and genotype of acute and fulminant hepatitis A virus. Methods: Serum samples obtained from 1009 cases of suspected acute viral hepatitis was employed for different biochemical and serological examination. RNA was extracted from blood serum, reverse transcribed into cDNA and amplified using nested PCR for viral quantification, sequencing and genotyping. Immunological cell count from freshly collected whole blood was carried out by fluorescence activated cell sorter. Results: Fulminant hepatitis A was mostly detected with other hepatic viruses. CD8 + T cells count increases in fulminant hepatitis to a significantly high level (P = 0.005) compared to normal healthy control. The immunological helper/suppressor (CD4 + /CD8 +) ratio of fulminant hepatitis was significantly lower compared to acute cases. The serologically positive patients were confirmed by RT-PCR and total of 72 (69.2%) were quantified and sequenced. The average quantitative viral load of fulminant cases was significantly higher (P < 0.05). There was similar genotypic distribution in both acute and fulminant category, with predominance of genotype IIIA (70%) compared to IA (30%). Conclusions: Immunological factors in combination with viral load defines the severity of the fulminant hepatitis A. Phylogenetic analysis of acute and fulminant hepatitis A confirmed genotypes IIIA as predominant against IA with no preference of disease severity.