Acute viral hepatitis in an adult hospital, from 1992 to 2001
DOI:
https://doi.org/10.51481/amc.v45i4.121Keywords:
hepatitis, virales, agudas, fulminantes, virus de hepatitis AAbstract
Objectives and justification: Due to the change that has been sensed in Costa Rica's daily clinical practice and confirmed in other countries regarding etiological distribution of acute viral hepatitis, it became clear the need of studying acute viral hepatitis infections, with more interest in the he-patitis Avirus because its clinical presentation in adults is more severe tan in children.
Methods: All cases of acute AB viral hepatitis were registered, from January 12, 1992 to December 28, 2001 at the Hospital Mexico. The diagnosis was made by detection of Ig Manti-HAV, HbsAg and IgM anti-HBc. All cases of fulminant hepatitis from the same period were studied also. The diagnosis and etiology of these cases were based on clinical and laboratory parameters.
Results:During the study on period, 587 cases of acute viral hepatitis were diagnosted, 235 by Avirus and 352 by B virus,this corresponds to a 40% and 60% respectively. Most of the cases were found between the ages of 20 and 60 years. Fiftythree percent of the cases occurred in men and 46,68% in women.
Thirty three fulminant hepatitis cases were registered. Fortyfive percent were caused by viral infection; 33,33% from virus A and 12,12% from virus B. Other pathologies like Wil-son disease, hepatotoxicity produced by the use of anesthetics and pregnancy fatty degeneration were found in smaller percentages. Two-point fifty six percent of acute viral hepatitis had a fulminant clinical presentation. Four-point seven percent of hepatitis A cases had a fulminant course.
The management of the patients with acute viral hepatitis was mainly conducted (62%) by the Out-patient Gastroenterology Service.
Conclusions: The predominant hepatitis infection in adults was caused by B virus. The etiological distribution was very similar to previous reports made decades ago for specific areas of the country, but the presentation of fulminant hepatitis Ahas increased (4,7%) considerably. The inclusion of vaccination against hepatitis A virus must be considered in the future of the national health system. This vaccine should be given at birth and applied to young patients and adults with high risk of acquiring severe infection.
Downloads
References
Esquivel J, Fernández L, Hevia F, Martén A, Mora J y Salom I. Diag-nóstico y prevención de las hepatitis virales. (1ª ed). EDNASSS-CCSS.San José, Costa Rica. 1990; 1-22.
Hadler SC. Global impact of hepatitis Avirus infection; changing pat-terns. En: Hollinger FB, Lemon SM, Margolis HS, eds. Viral hepatitisand liver diseases. Williams & Wilkins, Baltimore MD; 1991: 14-20.
Koff RS. Hepatitis A. Lancet 1998; 351: 1643-8.
Steffen R, DuPont HL. Hepatitis B. En: Manual of travel medicine andhealth. Hamilton, London & St. Louis. BC Decker Inc., 1999; 176-83.
Visoná KA, Eduarte CE, Zamora E, Salazar LM. Estudio epidemioló-gico de las hepatitis virales en San Ramón y Palmares de 1972-1985.Acta Med Costarric 1989; 33: 69-77.
Fauci et al. Harrison Principios de Medicina Interna. (14a ed). Vol. II:Cap. 295. España: Mc Graw-Hill Interamericana; 1998: 1904 -22.
Romero R, Lavine JE. Viral hepatitis in children. Semin Liver Disease1994; 14: 289-302.
Cuthbert JA. Hepatitis A: old and new. Clin Microbiol Rev 2001; 14:38-58.
Henning KJ, Bell E, Braun J, Barker ND. Acommunity-wide outbreakof hepatitis A: risk factors for infection among homosexual and bise-xual men. Am J Med 1995; 99: 132-6.
Lucioni C, Cipriani V, Mazzi S, Panunzio M. Cost of an outbreak he-patitis Ain Puglia, Italy. PharmacoEconomics 1998; 13: 257-66.
Hutin YJ, Pool V, Cramer EH, et al. Amultistate foodborne outbreak ofhepatitis A. N Engl J Med 1999; 340: 595-602.
Taylor ML, García Z, Holst I, et al. Seroprevalencia de los virus de lashepatitis Ay B en grupos etarios de Costa Rica. Acta Med Costarric2001; 43: 153-8.
Hollinger FB, Ticehurst JR. Hepatitis Avirus. En: Fields BN, KnipeDM, Peter MH, et al., eds. Virology. (3ª ed). Vol. 1: Part II. Specifc Vi-rus Families. Picornaviridae. Philadelphia. New York. Lippincott-Ra-ven Publishers; 1996: 735-782.
Takahashi J, Shimizu M. Etiology and prognosis of fulminant viral he-patitis in Japan: a multicentre study.The Study Group of Fulminant He-patitis. Gastroenterol Hepatol 1991; 6: 159-64.
O'Grady J. Management of acute and fulminant hepatitis A. Vaccine1992: 10 (supl. 1): S21-S23.
Acharya SK, Dasarathy S, Kumer TL, et al. Fulminant hepatitis in a tro-pical population: clinical course, cause, and early predictors of outco-me. Hepatology 1996; 23: 1448-55.
US Department of Health and Human Services. Prevention of hepatitisAthrough active or passive immunizations: recommendations of theAdvisory Committee on Immunisation Practices. MMWR. 1999; 48(RR-12): 1-37.
Thoelen S, Van Damme P, Leenvaar-Kuypers A, et al. The first combi-ned vaccine against hepatitis Aand B: an overview.Vaccine 1999; 17:1657-62.Hepatitis virales agudas/ Acuña J et al
Downloads
Published
Issue
Section
License
Copyright (c) 2008 Acta Médica Costarricense
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Los autores que publican en la revista Acta Médica Costarricense pueden distribuir, copiar, remezclar, retocar, leer, descargar, imprimir, buscar y crear a partir de su obra de modo no comercial, indicando los créditos a la revista y sus autores y compartir su obra en las mismas condiciones. Para ello se aplica la licencia Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional(CC BY-NC-SA 4.0)
