Prolonged Cholestasis Following Acute Hepatitis A Infection: Case Report and a Review of Literature

Alebaji, Mohamad B; Mehair, Alaa S; Shahrour, Ola I; Elkhatib, Feryal A; Alkaabi, Eiman H; Alkuwaiti, Najla S

doi:10.7759/cureus.38511

Cureus

2023

DOI: 10.7759/cureus.38511

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Prolonged Cholestasis Following Acute Hepatitis A Infection: Case Report and a Review of Literature

Mohamad B Alebaji¹,

Alaa S Mehair²,

Ola I Shahrour³

et al.

Abstract: Prolonged cholestasis is a rare complication of hepatitis A infection, characterized by a protracted, indolent course with persistent symptoms of pruritus and malabsorption lasting for several months. A 14-year-old girl, previously treated for acute hepatitis A, presented with yellowing of the eyes. An evaluation of her liver function revealed conjugated hyperbilirubinemia, and a liver biopsy confirmed hepatitis with cholestasis. Fortunately, she responded well to conservative treatment and recovered successfu… Show more

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2024

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Cited by 2 publications

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Zoonotic and Food-Related Hazards Due to Hepatitis A and E in Africa: A Systematic Review and Meta-Analysis

Odoom,

Boamah,

Sagoe

et al. 2024

Environ�Health�Insights

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Introduction: Foodborne infections are caused by a wide spectrum of microbial pathogens, and they pose a significant global health threat, resulting in millions of cases and thousands of fatalities annually. Among these pathogens, human viruses, including Hepatitis A virus (HAV) and Hepatitis E virus (HEV), play a significant role in foodborne viral outbreaks, especially in Africa. This systematic review determined the prevalence of these viruses in livestock and produce in Africa. Method: A systematic search strategy was implemented following the PRISMA guidelines. Databases such as African Journal Online, Web of Science, Scopus, and PubMed were searched from their inception until November 30, 2023. Descriptive statistics and a proportional meta-analysis utilising a random-effects model with a 95% confidence interval were employed in the data analysis. The Cochrane risk-of-bias tool (ROB2) was utilised to evaluate the potential for bias in each study. Results: The search identified 27 articles that met the inclusion criteria, among which seven focused on HAV, comprising a total of 309 samples, whereas 20 studies focused on HEV, comprising a total of 4238 samples. Egypt had the highest number of studies, followed by Cameroon and Nigeria. The meta-analysis revealed an overall prevalence of 33.8% (95% CI: 17.0–50.6) for HAV in ducks and shellfish and 22.0% (95% CI: 12.1–31.8) for HEV in various livestock. Genotype 3 was identified as the predominant genotype, for both HAV and HEV. Conclusion: This review revealed a high prevalence of HAV and HEV in livestock populations in Africa, shedding light on the potential risks associated with zoonotic and/or food-related infections. There is a need for continued surveillance and monitoring of these viruses in both animals and food products to mitigate the risk of foodborne outbreaks and protect human health.

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Zoonotic and Food-Related Hazards Due to Hepatitis A and E in Africa: A Systematic Review and Meta-Analysis

Odoom,

Boamah,

Sagoe

et al. 2024

Environ�Health�Insights

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show abstract

Hyperbilirubinemia and transaminitis in hepatitis A: case report on early remission through ayurveda interventions

Panda

2024

JPMHH

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Hepatitis A is a common cause for acute hepatitis and jaundice. It is mostly self-limiting requires no or suppurative treatment and very rare cases prolong jaundice, liver failure and death. Prolonged jaundice types of cases are mostly going to folk healers and herbalist. Ayurveda has no recordable evidence of course of treatment in Hepatitis A. Therefore, this case paper will be a notable evidence for Ayurveda in hepatitis A. A 43-year female came to hospital with an one week history of lethargy, anorexia, weight loss and yellow discoloration of urine. The patient has Hepatitis A (HAV) IgM antibody positive with other viral profile negative and elevated bilirubin(6.28mg/dl) and high transaminase (SGOT-824U/L and SGPT 1263 U/L). Arogyavardhini Vati, Liv 52Hb and Phalatrikadi Kwatha were administrated in its standard doses as these regimen have Agnideepak(Carminative), Srotosothaka (channel purifier), Mrudu virechana ( Mild purgative)properties, but no signicant change in liver function test . then ( Siddha Makardwaja Rasa) is added to reduce liver inflammation and possible involvement of cholangitis. The physical strength , appetite was normalised along with normalisation of bilirubin and liver transaminase within three weeks of the therapy. The combination of therapy may reduce the bile acid cytotoxicity of bile and, possibly, decrease of the concentration of hydrophobic bile acids in the cholangiocyte. As Siddha Makardwaja special is in metallic oxide form (Au/HgO), it may be acts as an anti-inflammatory drug by reducing pro inflammatory cytokine expression, blocking leucocyte adhesion and decreasing oxidative stress due to infection. This case report is preliminary evidence for further stresses the significance of Siddha Makardwaja Rasayana along with other Ayurveda formulations in early remission of high bilirubin and liver transaminase in Hepatitis A infection. This treatment regimen can be used for local epidemic of Hepatitis A for appropriate Ayurveda management after randomised clinical trial.

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Prolonged Cholestasis Following Acute Hepatitis A Infection: Case Report and a Review of Literature

Cited by 2 publications

References 15 publications

Zoonotic and Food-Related Hazards Due to Hepatitis A and E in Africa: A Systematic Review and Meta-Analysis

Zoonotic and Food-Related Hazards Due to Hepatitis A and E in Africa: A Systematic Review and Meta-Analysis

Hyperbilirubinemia and transaminitis in hepatitis A: case report on early remission through ayurveda interventions

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