Hepatitis A virus in stool during clinical relapse.
Among 256 patients with acute hepatitis A, 17 (6.6%) had a relapse of the disease between 30 and 90 days after the primary episode. We studied 7 of these patients. Serologic testing showed mean alanine aminotransferase levels of 1668 IU/L during the acute stage, 107 IU/L during the early convalescence, and 1027 IU/L during the relapse. Tests for IgM antibody against hepatitis A virus were positive in the 7 patients at the onset of disease, with decreasing levels in 3 of the 4 patients tested during the evolution of the illness. Stools collected during the relapse phase showed hepatitis A virus by immune electron microscopy, radioimmunoassay, and molecular hybridization using a 32P-labeled cDNA-hepatitis A virus probe. Stools collected from 4 of these patients 6 to 12 months after the onset of disease were negative for the virus. The finding of hepatitis A virus in the stool of these patients during the relapse phase strongly implicates hepatitis A virus as the causative agent of the clinical relapse.
D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D002648:Child; D003289:Convalescence; D005243:Feces / Q000382:microbiology*; D005260:Female; D006506:Hepatitis A / Q000382:microbiology*; D006508:Hepatitis Antibodies / Q000032:analysis; D006507:Hepatovirus / Q000302:isolation & purification*; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D008297:Male; D008854:Microscopy, Electron; D009693:Nucleic Acid Hybridization; D011863:Radioimmunoassay; D012008:Recurrence
D006508:Hepatitis Antibodies; D007075:Immunoglobulin M; D000410:Alanine Transaminase