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Acute sporadic non‐A, non‐B, non‐C, non‐D, non‐E hepatitis
Author(s) -
Rochling F A,
Jones W F,
Chau K,
DuCharme L,
Mimms L T,
Moore B,
Scheffel J,
Cuthbert J A,
Thiele D L
Publication year - 1997
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.510250237
Subject(s) - medicine , gastroenterology , hypoalbuminemia , hepatitis , jaundice , hepatitis c , hepatitis c virus , hepatitis a , immunology , virus
Patients presenting with clinical and laboratory features consistent with a diagnosis of acute non‐A, non‐B hepatitis were evaluated for evidence of hepatitis C or hepatitis E infection and for evidence of severe or prolonged disease. Antibody to hepatitis C virus (anti‐HCV) was detected in 75 of 108 (69%) patients, antibody to hepatitis E virus (anti‐HEV) in three patients (3%), and neither antibody in 31 (29%) patients. One patient had both anti‐HCV and anti‐HEV. HCV RNA was not detected in sera from any of 20 patients with seronegative (non‐ABCDE) hepatitis, but in all 10 patients with anti‐HCV who were tested by polymerase chain reaction (PCR). Compared with patients with acute hepatitis C, those with non‐ABCDE hepatitis had a lower incidence of parenteral risk factors (6% vs. 70%; P < .001), higher peak serum bilirubin levels (45% vs. 5% with peak levels > 15 mg/dL; P < .001), more prolonged jaundice (25% vs. 0% with peak bilirubin >5 weeks after onset; P < .01), more severe prothrombin time abnormalities (26% vs. 0% with >3 second prolongation; P < .001), more severe hypoalbuminemia (39% vs. 9% with albumin <3 g/dL; P < .01), and more frequent major clinical complications (13% vs. 0% with encephalopathy; P < .01; 10% vs. 0% with death or transplant; P = .024). Patients with acute non‐ABCDE hepatitis were less likely to develop chronic hepatitis than those with acute hepatitis C (23% vs. 68%; P < .05). Thus, patients with acute non‐ABCDE hepatitis are epidemiologically distinct from those with acute hepatitis C and have a significantly more severe acute illness.