Does Mutation of Hepatitis A Virus Exist in North India?

Hussain, Zahid; Husain, Syed Akhtar; Pasha, Syed Tazeen; Anand, Ranjana; Chand, Abdullah; Polipalli, Sunil Kumar; Rehman, Shabeena; Kar, Premashis

doi:10.1007/s10620-007-9870-9

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…Therefore, nucleotide variations in the central portion of the 5 noncoding region of HAV may influence the severity of hepatitis A [13] . However, a recent study from India reported no evidence of HAV genome variation according to the severity of hepatitis, which warrants further study on the existence of HAV mutations associated with disease severity [14] .…”

Section: Other Extrahepatic Manifestationsmentioning

confidence: 80%

Hepatitis A: Clinical Manifestations and Management

Jeong¹,

Lee²

2010

Intervirology

194

156

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Due to improved living conditions and subsequent changes in hepatitis A epidemiology, the disease burden of hepatitis A is increasing in many regions. Recently, Korea has faced a large, community-wide outbreak of hepatitis A, which has prompted a vaccination program. The clinical spectrum of hepatitis A virus infection ranges from asymptomatic infection to fulminant hepatitis. Clinical manifestations depend on the age of the host: less than 30% of infected young children are symptomatic, while about 80% of infected adults manifest severe hepatitis with remarkably elevated serum aminotransferases. Fulminant hepatitis is rare, with a reported incidence from 0.015 to 0.5%. Atypical manifestations include relapsing hepatitis and prolonged cholestasis, and complicated cases with acute kidney injury have been reported. Extrahepatic manifestations, such as autoimmune hemolytic anemia, aplastic anemia, pure red cell aplasia, pleural or pericardial effusion, acute reactive arthritis, acute pancreatitis, acalculous cholecystitis, mononeuritis, and Guillain-Barré syndrome, have been rarely reported. Management of hepatitis A includes general supportive care, and critical decisions regarding liver transplantation await further studies on prognostic predictors. Fundamental management of hepatitis A is active vaccination. However, a vaccination program should be adapted to the regional situation, according to differing epidemiology and disease burden.

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Section: Other Extrahepatic Manifestationsmentioning

confidence: 80%

Hepatitis A: Clinical Manifestations and Management

Jeong¹,

Lee²

2010

Intervirology

194

156

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“…If a correlation can be confirmed in a large number of patients, the HAV RNA titer and its dynamic changes would be good markers for predicting s-AH. Finally, although a previous article reported that the HAV genotype and genome variations may not be the main factor in AHA severity, we did not determine HAV genotype or viral sequence variations [ 25 – 27 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Factors and Viral Load Influencing Severity of Acute Hepatitis A

et al. 2015

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Background and AimsClinical manifestations of hepatitis A virus (HAV) infection vary from mild to fulminant hepatic failure (FHF) in adults. We investigated the relationship between laboratory findings, including viral load, and clinical outcomes in patients with acute hepatitis A (AHA) and evaluated predictive factors for severe acute hepatitis (s-AH).MethodsWe analyzed the clinical manifestations of AHA in 770 patients. Patients with a prothrombin time (PT) of less than 40% of normal were classified as s-AH and included 4 patients with FHF, 11 patients with acute renal failure, and 3 patients with prolonged jaundice (n = 128). Other patients were defined as mild acute hepatitis (m-AH) (n = 642). Serum samples were obtained from 48 patients with acute hepatitis A. Among them, 20 with s-AH, and 28 with m-AH, were tested for HAV RNA titer.ResultsIn a multivariate analysis, age (HR = 1.042, P = 0.041), peak creatinine (HR = 4.014, P = 0.001), bilirubin (HR = 1.153, P = 0.003), alanine aminotransferase (ALT) (HR = 1.001, P<0.001), initial lactate dehydrogenase (LDH) (HR = 1.000, P = 0.045) and total cholesterol (HR = 0.978, P<0.001) were independent factors for s-AH. Serum HAV RNA was detected in 20/20 (100%) patients with s-AH and 22/28 (78.6%) patients with m-AH. In a multivariate analysis of the 48 patients who were tested for HAV RNA, peak ALT (HR = 1.001, P = 0.004) and HAV RNA titer (HR = 2.076, P = 0.012) were independent factors for s-AH.ConclusionsClinical factors including age, peak creatinine, bilirubin, ALT, initial LDH and total cholesterol were independent factors for s-AH in a multivariate analysis. In particular, HAV load strongly correlated with the severity of hepatitis A.

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Viral Hepatitis

Reynolds

2013

Sexually Transmitted Diseases

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Does Mutation of Hepatitis A Virus Exist in North India?

Cited by 4 publications

References 21 publications

Hepatitis A: Clinical Manifestations and Management

Hepatitis A: Clinical Manifestations and Management

Clinical Factors and Viral Load Influencing Severity of Acute Hepatitis A

Viral Hepatitis

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