Clinical and virological characteristics associated with severe acute hepatitis B. (12th December 2014)

• Record Type: Journal Article
• Authors: Coppola, N.; Sagnelli, C.; Pisaturo, M.; Minichini, C.; Messina, V.; Alessio, L.; Starace, M.; Signoriello, G.; Gentile, I.; Filippini, P.; Sagnelli, E.; Antonelli, G
• Is Part Of: Clinical microbiology and infection. Volume 20:Number 12(2014:Dec.)
• Page Start: O991
• Page End: O997
• Publication Date: 2014-12-12
• Subjects: Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1111/1469-0691.12720
• Languages: English
• ISSNs: 1198-743X

Abstract

<abstract abstract-type="main" id="clm12720-abs-0001"> <title>Abstract</title> <p>To identify early predictors of a severe or fulminant course in patients with acute viral hepatitis B (AVH‐B). One hundred and thirty‐eight patients with symptomatic acute hepatitis B observed from 1999 to 2012 were enrolled. For each patient, the demographics, risk factors for the acquisition of hepatitis B virus (HBV) infection, clinical, biochemical and virological data (HBV DNA, HBV DNA sequences) were recorded and analysed. The HBV mutants in the polymerase region were sought in 110 (87%) patients by direct sequencing, and the rtM204V/I mutations also by an allele‐specific PCR. AVH‐B was severe in 13 (9.4%) of the 138 patients enrolled, fulminant in 6 (4.3%) and with a normal clinical course in 119. The 19 patients with severe or fulminant AVH‐B more frequently than the 119 with a normal course stated intravenous drug use (63.2% versus 36.1%, p 0.04) and were HBV‐DNA negative (31.6% versus 11.8%, p 0.03) and anti‐hepatitis C virus (HCV) positive (57.9% versus 19.3%, p 0.0008); the prevalences of different HBV genotypes and of the rtM204V/I mutant were similar in these three forms of AVH‐B. A multivariate logistic regression analysis identified a pre‐existing HCV chronic infection as the only factor independently associated with a severe or fulminant clinical course of AVH‐B (OR 4.89, 95% CI 1.5–15.94, p 0.01). A pre‐existing HCV chronic infection was identified as the only factor independently associated with a severe clinical presentation of acute hepatitis B, an association most probably due to the combination of the liver lesions caused by acute hepatitis B and the pre‐existing histological abnormalities related to HCV chronic infection.</p> </abstract>