Epidemiological characteristics, risk factors, and clinical manifestations of acute non‐A–E hepatitis

Abstract

A substantial proportion of acute non-A, non-B hepatitis was of unknown etiology and was termed non-A-E hepatitis. Analysis of the clinical features is needed while attempting to identify the causative agent(s). In this study, the clinical and biochemical features of 53 patients who were admitted to hospital with acute non-A-E hepatitis were compared with a cohort of patients with acute hepatitis C (n = 70) and E (n = 5). In acute non-A-E hepatitis, the sex ratio was 34:19, and ages ranged from 21 to 76 years (median 49). Biochemical tests [median (range)] revealed albumin 3.6 (2.2-4.4) g/dl, AST 714 (193-2311) U/l, ALT 896 (310-3,000) U/l, bilirubin 11.2 (0.9-36.3) mg/dl, and prothrombin time > 1.1 (0-11.5) seconds. No patients reported parenteral exposures or household contact. Forty-five percent had severe hepatitis (i.e., albumin < 3 g/dl, bilirubin > 15 mg/dl or prothrombin time > 3 sec), including 3% with fulminant hepatitis. Chronic evolution was noted in 7%. These features were similar to those of hepatitis C or E, except for a significantly high frequency of parenteral exposures (20%), household contact (16%), and chronicity (70%) in hepatitis C. In conclusion, there is no obvious parenteral risk factor identified in acute non-A-E hepatitis. Clinical severity is similar to that of hepatitis C at least in hospitalized patients, but the rate of chronic evolution is much lower.

Emerging Viral Infections

“…Moreover, the sensitivity of the RIDTs also seemed to vary with different influenza virus strains (Centers for Disease Control and Prevention, 2009). The failure rates in determining the etiological cause for example in encephalitis, acute flaccid paralysis, and non A-E hepatitis were reportedly 30-85% (Granerod and Crowcroft, 2007), 12% (Saeed et al, 2007), and 18-62% (Chu et al, 2001), respectively. In a relatively large proportion of patients suffering from diarrhea (Finkbeiner et al, 2008) and acute respiratory illnesses (Juven et al, 2000), no pathogens could be detected, despite the use of a wide range of sensitive diagnostic assays.…”

Exploring the Potential of Next-Generation Sequencing in Detection of Respiratory Viruses

“…L aboratories nowadays largely perform viral species-specific assays for virus diagnosis in clinical samples to increase the sensitivity of detection and reduce the time needed for diagnosis. However, an etiological agent cannot be identified in many cases despite the use of a wide range of sensitive diagnostic assays (1)(2)(3)(4)(5). This can depend on the timing of sampling, performance of the individual assays, and also the involvement of divergent viruses that are not detected due to the high specificity of the assays.…”

Human Picobirnaviruses Identified by Molecular Screening of Diarrhea Samples

“…For virus identification in clinical samples, laboratories nowadays perform largely viral-speciesspecific assays to increase the sensitivity of detection and reduce the time needed for diagnosis. Although these diagnostic assays are successful, failure rates in determining the etiological cause can vary significantly (11,19,31) because of limited detection of divergent viruses due to the high specificity of the assays. The discovery of new viruses with these assays remains rare.…”