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Viruses Feb 2020One patient presented hyporexia, asthenia, adynamia, and jaundice two months after acute yellow fever (YF) onset; plus laboratory tests indicating hepatic cytolysis and...
One patient presented hyporexia, asthenia, adynamia, and jaundice two months after acute yellow fever (YF) onset; plus laboratory tests indicating hepatic cytolysis and a rebound of alanine and aspartate transaminases, and total and direct bilirubin levels. Laboratory tests discarded autoimmune hepatitis, inflammatory or metabolic liver disease, and new infections caused by hepatotropic agents. Anti-YFV IgM, IgG and neutralizing antibodies were detected in different times, but no viremia. A liver biopsy was collected three months after YF onset and tested positive for YFV antigens and wild-type YFV-RNA (364 RNA-copies/gram/liver). Transaminases and bilirubin levels remained elevated for five months, and the arresting of symptoms persisted for six months after the acute YF onset. Several serum chemokines, cytokines, and growth factors were measured. A similar immune response profile was observed in the earlier phases of the disease, followed by more pronounced changes in the later stages, when transaminases levels returned to normal. The results indicated viral persistence in the liver and continual liver cell damage three months after YF onset and reinforced the need for extended follow-ups of YF patients. Further studies to investigate the role of possible viral persistence and the immune response causing relapsing hepatitis following YF are also necessary.
Topics: Acute Disease; Antibodies, Neutralizing; Antibodies, Viral; Biopsy; Cytokines; Hepatitis A; Humans; Jaundice; Liver; Liver Function Tests; Male; Middle Aged; Recurrence; Time Factors; Yellow Fever; Yellow fever virus
PubMed: 32079143
DOI: 10.3390/v12020222 -
Gut and Liver Mar 2016The immunoregulatory molecules programmed death 1 (PD-1) and cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) are associated with the dysfunction of antiviral...
BACKGROUND/AIMS
The immunoregulatory molecules programmed death 1 (PD-1) and cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) are associated with the dysfunction of antiviral effector T-cells, which leads to T-cell exhaustion and persistent viral infection in patients with chronic hepatitis C and chronic hepatitis B. Little is known about the role of PD-1 and CTLA-4 in patients with symptomatic acute hepatitis A (AHA).
METHODS
Peripheral blood mononuclear cells were isolated from seven patients with AHA and from six patients with nonviral acute toxic hepatitis (ATH) during the symptomatic and convalescent phases of the respective diseases; five healthy subjects acted as controls. The expression of PD-1 and CTLA-4 on T-cells was measured by flow cytometry.
RESULTS
PD-1 and CTLA-4 expression during the symptomatic phase was significantly higher in the T-cells of AHA patients than in those of ATH patients or healthy controls (PD-1 18.3% vs 3.7% vs 1.6%, respectively, p<0.05; CTLA-4 23.5% vs 6.1% vs 5.9%, respectively, p<0.05). The levels of both molecules decreased dramatically during the convalescent phase of AHA, whereas a similar pattern was not seen in ATH.
CONCLUSIONS
Our findings are consistent with a viral-protective effect of PD-1 and CTLA-4 as inhibitory molecules that suppress cytotoxic T-cells and thereby prevent the destruction of virus-infected hepatocytes in AHA.
Topics: Acute Disease; Adult; CTLA-4 Antigen; Case-Control Studies; Female; Flow Cytometry; Hepatitis; Hepatitis A; Hepatitis A Virus, Human; Humans; Male; Phenotype; Programmed Cell Death 1 Receptor; T-Lymphocytes
PubMed: 26347518
DOI: 10.5009/gnl14368 -
Journal of Korean Medical Science Sep 2022Although anti-hepatitis A virus (HAV) IgM non-reactive and anti-HAV total (immunoglobulin [Ig] M and IgG) reactive results are generally interpreted as immunity to HAV,...
Although anti-hepatitis A virus (HAV) IgM non-reactive and anti-HAV total (immunoglobulin [Ig] M and IgG) reactive results are generally interpreted as immunity to HAV, some early acute hepatitis A patients show the same results. We compared IgM detection sensitivity between anti-HAV IgM and anti-HAV total assays. Acute hepatitis A patients' samples were serially diluted and tested with Elecsys anti-HAV IgM and total assay (Roche Diagnostics). This resulted in anti-HAV IgM non-reactive but anti-HAV total reactive results. Samples of two hepatitis A patients showing false-negative anti-HAV IgM at initial presentation were analyzed with Elecsys, Atellica (Siemens Healthineers), and Alinity (Abbott Laboratories) HAV assays. Elecsys, Atellica, and Alinity anti-HAV IgM converted reactive on hospital day 3, whereas Elecsys and Atellica anti-HAV total results were reactive from hospital day 1. The anti-HAV total assay had higher sensitivity in detecting IgM antibodies than the anti-HAV IgM assay.
Topics: Acute Disease; Hepatitis A; Hepatitis A Antibodies; Humans; Immunoglobulin G; Immunoglobulin M
PubMed: 36163480
DOI: 10.3346/jkms.2022.37.e287 -
Annals of Global Health Mar 2020Hepatitis A virus (HAV) and hepatitis E virus (HEV) are transmitted by the fecal-oral route and are responsible for epidemic and sporadic outbreaks of acute hepatitis in...
BACKGROUND
Hepatitis A virus (HAV) and hepatitis E virus (HEV) are transmitted by the fecal-oral route and are responsible for epidemic and sporadic outbreaks of acute hepatitis in low-income countries like Bangladesh.
OBJECTIVE
The purpose of this study was to describe the seroprevalence of acute hepatitis due to HAV and HEV infection in Bangladesh.
METHODS
The nationwide food-borne illness surveillance started in 2014 at 10 different hospitals which covered seven divisions of Bangladesh. Blood samples were collected from suspected acute hepatitis cases and screened for the anti-HAV IgM and anti-HEV IgM using enzyme-linked immunosorbent assay (ELISA). Participants' socioeconomic status, clinical, sanitation and food history were recorded. Multivariate logistic regression was performed to determine the risk factors associated with HAV and HEV infection.
FINDINGS
A total of 998 patients were enrolled and tested for both HAV and HEV. Among these, 19% (191/998) were identified as HAV positive and 10% (103/998) were HEV positive. The median age was 12 years and 25 years for HAV and HEV positive patients, respectively. The prevalence of HAV was higher among the females (24.9%), whereas HEV was higher among males (11.2%). The highest occurrence of HAV was observed among children while HEV was most prevalent in the 15-60 years age group (12.4%).
CONCLUSION
Through our nationwide surveillance, it is evident that hepatitis A and hepatitis E infection is common in Bangladesh. These data will be useful towards planning preventive and control measures by strengthening the sanitation programs and vaccination strategies in Bangladesh.
Topics: Acute Disease; Adolescent; Adult; Age Distribution; Bangladesh; Child; Child, Preschool; Enzyme-Linked Immunosorbent Assay; Female; Hepatitis A; Hepatitis A Antibodies; Hepatitis Antibodies; Hepatitis E; Humans; Immunoglobulin M; Infant; Infant, Newborn; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prevalence; Seroepidemiologic Studies; Sex Distribution; Young Adult
PubMed: 32211299
DOI: 10.5334/aogh.2574 -
The American Journal of Pathology Dec 1975The basis for the epidemiologic and etiologic differentiation of two major forms of viral hepatitis, hepatitis A and B, was established in a series of studies undertaken... (Review)
Review
The basis for the epidemiologic and etiologic differentiation of two major forms of viral hepatitis, hepatitis A and B, was established in a series of studies undertaken between 1930 and 1970. Final recovery and visualization of the presumed etiologic agent of hepatitis A was not, however, accomplished until the technique of immune electron microscopy was applied to the examination of specimen materials collected from individuals in the early acute stages of infection. Morphologically homogeneous virus-like particles of 27 nm diameter have now been recovered from stools of patients with hepatitis A ill from a variety of sources. Antibody to these particles has been shown to develop during the course of infection with hepatitis A but not with hepatitis B and disease has been induced in nonhuman primates inoculated with purified particle containing fractions. The classification of hepatitis A virus has not been conclusively established, but it would appear to be either a parvovirus or an enterovirus.
Topics: Antibodies, Viral; Enterovirus; Hepatitis A; Hepatovirus; Humans; Parvoviridae
PubMed: 174435
DOI: No ID Found -
Clinical Microbiology Reviews Jan 2001The hepatitis A virus (HAV), a picornavirus, is a common cause of hepatitis worldwide. Spread of infection is generally person to person or by oral intake after fecal... (Review)
Review
The hepatitis A virus (HAV), a picornavirus, is a common cause of hepatitis worldwide. Spread of infection is generally person to person or by oral intake after fecal contamination of skin or mucous membranes; less commonly, there is fecal contamination of food or water. Hepatitis A is endemic in developing countries, and most residents are exposed in childhood. In contrast, the adult population in developed countries demonstrates falling rates of exposure with improvements in hygiene and sanitation. The export of food that cannot be sterilized, from countries of high endemicity to areas with low rates of infection, is a potentially important source of infection. After ingestion and uptake from the gastrointestinal tract, the virus replicates in the liver and is excreted into the bile. Cellular immune responses to the virus lead to destruction of infected hepatocytes with consequent development of symptoms and signs of disease. Humoral immune responses are the basis for diagnostic serologic assays. Acute HAV infection is clinically indistinguishable from other causes of acute viral hepatitis. In young children the disease is often asymptomatic, whereas in older children and adults there may be a range of clinical manifestations from mild, anicteric infection to fulminant hepatic failure. Clinical variants include prolonged, relapsing, and cholestatic forms. Management of the acute illness is supportive, and complete recovery without sequelae is the usual outcome. Research efforts during World War II led to the development of passive immunoprophylaxis. Pooled immune serum globulin is efficacious in the prevention and attenuation of disease in exposed individuals. More recently, active immunoprophylaxis by vaccination has been accomplished. Future eradication of this disease can now be contemplated.
Topics: Hepatitis A; Hepatitis A Vaccines; Hepatitis A Virus, Human; Humans; Infection Control; Risk Factors
PubMed: 11148002
DOI: 10.1128/CMR.14.1.38-58.2001 -
Pathogenicity and virulence of human adenovirus F41: Possible links to severe hepatitis in children.Virulence Dec 2023Over 100 human adenoviruses (HAdVs) have been isolated and allocated to seven species, A-G. Species F comprises two members-HAdV-F40 and HAdV-F41. As their primary site... (Review)
Review
Over 100 human adenoviruses (HAdVs) have been isolated and allocated to seven species, A-G. Species F comprises two members-HAdV-F40 and HAdV-F41. As their primary site of infection is the gastrointestinal tract they have been termed, with species A, enteric adenoviruses. HAdV-F40 and HAdV-F41 are a common cause of gastroenteritis and diarrhoea in children. Partly because of difficulties in propagating the viruses in the laboratory, due to their restrictions on growth in many cell lines, our knowledge of the properties of individual viral proteins is limited. However, the structure of HAdV-F41 has recently been determined by cryo-electron microscopy. The overall structure is similar to those of HAdV-C5 and HAdV-D26 although with some differences. The sequence and arrangement of the hexon hypervariable region 1 (HVR1) and the arrangement of the C-terminal region of protein IX differ. Variations in the penton base and hexon HVR1 may play a role in facilitating infection of intestinal cells by HAdV-F41. A unique feature of HAdV-F40 and F41, among human adenoviruses, is the presence and expression of two fibre genes, giving long and short fibre proteins. This may also contribute to the tropism of these viruses. HAdV-F41 has been linked to a recent outbreak of severe acute hepatitis "of unknown origin" in young children. Further investigation has shown a very high prevalence of adeno-associated virus-2 in the liver and/or plasma of some cohorts of patients. These observations have proved controversial as HAdV-F41 had not been reported to infect the liver and AAV-2 has generally been considered harmless.
Topics: Humans; Child; Child, Preschool; Adenoviruses, Human; Virulence; Cryoelectron Microscopy; Adenovirus Infections, Human; Hepatitis; Hepatitis A; Phylogeny
PubMed: 37543996
DOI: 10.1080/21505594.2023.2242544 -
British Medical Journal Oct 1961
Topics: Alcoholism; Hepatitis; Hepatitis A; Hepatitis, Alcoholic; Humans
PubMed: 13866411
DOI: 10.1136/bmj.2.5260.1113 -
Journal of the Royal College of... Apr 1981
Topics: Acute Disease; Adult; Carrier State; Child; Child, Preschool; Hepatitis A; Hepatitis B; Hepatitis B virus; Hepatitis C; Hepatitis, Viral, Human; Hepatovirus; Humans; Immunization; Male
PubMed: 6268782
DOI: No ID Found -
British Medical Journal Sep 1965
Topics: Adolescent; Child; Child, Preschool; Hepatitis A; Humans; Infant; Infant, Newborn; Scotland
PubMed: 5826912
DOI: 10.1136/bmj.2.5461.593