Viral Hepatitis A in 108 Adult Patients During an Eight-Year Observation in a Single Center in Poland

Abstract

Background. Hepatitis A is related to significant morbidity and occasional mortality. Based on data from the Polish National Institute of Hygiene, from 2000 to 2013 a mean of 213 hepatitis A cases were reported yearly. Objectives. The aim of the study was to assess selected data in adults hospitalized for symptomatic hepatitis A during an eight-year period in a single center in the Wielkopolska Region of Poland. Material and Methods. All the hepatitis A patients hospitalized in the center from 2005 to 2013 were analyzed retrospectively. Data were extracted from the medical records of these individuals. The disease was confirmed by anti-HAV IgM testing. Results. In total, 108 patients (71 men and 37 women), aged 18-65 years, were identified. All but 1 patient recovered (99.1%) and in 6 cases (5.6%) a relapse occurred. Risk factors for hepatitis A were identified in 56 patients (52%), with travel abroad being the most common one (32 patients); 19 cases were secondary and 5 patients were men who have sex with men. One hepatitis A outbreak was noted in the region during the study period. Acalculous cholecystitis was found in 33.3% of the patients who underwent abdominal ultrasound. This tended to be more common among older individuals (47.8% in patients over 40 vs. 22.6% in patients aged 18-40, p = 0.0521). Patients with this finding had significantly higher mean peak ALT in comparison to those with no gallbladder abnormalities. Conclusions. Although hepatitis A in adults is typically a benign, self-limited disease, it can occasionally have a fatal course. In a significant proportion of patients with an evident risk factor for hepatitis A, the possibility of active prophylaxis was not used. Hepatitis A should be regarded as a sexually transmitted infection. Acalculous cholecystitis is a frequent finding among adults with symptomatic hepatitis A (Adv Clin Exp Med 2015, 24, 5, 829-836).

Hepatitis C Virus-Associated Acalculous Cholecystitis and Review of the Literature

“…While viral hepatic infections are an unusual etiology for acute calculous cholecystitis (ACC), most cases have been related to EBV, HAV, and HBV. 6,7,10 HCV is a member of the Flaviviridae family and is characterized by a single positive-strand RNA genome that can be divided into seven genotypes. 16 Acquisition of HCV most often results in chronic infection and inflammation leading to serious liver damage such as cirrhosis and hepatocellular carcinoma.…”

“…Whereas ACC is considered a local gallbladder disease process, AAC is typically a manifestation of systemic critical illness. [1][2][3][4][5][6]19 A recent prospective study by Laurila and colleagues 19 analyzing 84 gallbladder tissue samples among patients with AAC reported biliary infiltration into the mucosa and muscular layers, leukocyte arterial margination with nonthrombotic hypoperfusion (ischemia), focal lymphatic dilatation with interstitial edema, and less epithelial degeneration (necrosis) when histologically compared to ACC samples. A microangiography study by Hakala and colleagues 20 among 15 gallbladder samples also reported that nonthrombotic small arterial occlusion was a consistent feature of AAC when compared to ACC.…”

“…4,5 Viral infections associated with AAC most commonly are associated with Epstein-Barr virus (EBV); however, other viral pathogens include cytomegalovirus (CMV), dengue virus, hepatitis A (HAV), hepatitis B (HBV), human immunodeficiency virus (HIV), disseminated visceral varicella-zoster virus (VZV) infection, and Zika virus. [6][7][8][9][10][11][12][13] Infection with hepatitis C virus (HCV) has recently been reported in association with AAC. [14][15][16] The purpose of this communication is to report a case of HCV associated acalculous cholecystitis.…”

Sero-prevalence and Risk Factors for Hepatitis A Virus Infection among Pregnant Women at the Samandin Medical Center, Ouagadougou, Burkina Faso

“…These high prevalences could be related to the source of water supply and sanitation, and individual social characteristics of those who did not change behaviors toward the prevention and awareness of the disease [33,34]. In addition, young adults appear to be the most exposed to the external environment there by exposing them to the virus [35][36][37]. In this study, the prevalence of HAV infection among women living in unsanitary and underserved areas (Peripheral, 90.7%) was higher than women living in serviced areas (Center, 88.3%) ( Table 4).…”

Effectiveness of hepatitis A vaccination as post-exposure prophylaxis

“…5 The disease may also be complicated by extra-hepatic manifestations. 6 On rare occasions, HAV infection results in fulminant disease with case-fatality rates as high as 60%, 2 and patients with chronic liver disease are at increased risk for severe or fulminant disease requiring urgent liver transplantation due to liver failure. The major factors associated with the worst outcomes include age, underlying liver disease and co-infection with other hepatotropic viruses.…”