The role of hepatitis C virus in fulminant viral hepatitis in an area with endemic hepatitis A and B.
OBJECTIVE
The role of hepatitis C virus in fulminant hepatitis remains controversial and needs further investigation. The aim of this study was to examine the role of hepatitis C virus in fulminant hepatitis in an area with endemic hepatitis A and B.


METHODS
Serological markers of hepatitis C virus were studied in 62 adults from Taiwan with fulminant viral hepatitis.


RESULTS
Of 62 patients, 5 (8.1%) were infected with acute type B hepatitis, 11 (17.7%) were infected with acute non-A, non-B hepatitis, and the remaining 46 (74.2%) were hepatitis B surface antigen (HBsAg) positive but immunoglobulin M (IgM) antibody to hepatitis B core antigen negative. Of the latter, 11 (23.9%) were IgM antibody to hepatitis D virus positive, 16 (34.8%) had high-titered serum hepatitis B virus DNA (> 1000 pg/mL) and were suspected to have hepatitis B virus reactivation, and the other 19 (41.3%) had no identified causes. Serum hepatitis C virus RNA was found in 5 (45.5%) of 11 patients with fulminant non-A, non-B hepatitis, 3 (27.3%) of 11 HBsAg carriers with delta superinfection, and 6 (31.6%) of 19 HBsAg carriers with fulminant hepatitis of undetermined cause.


CONCLUSIONS
Nearly half of fulminant non-A, non-B hepatitis and about 20% of HBsAg carriers with superimposed fulminant hepatitis in Taiwan could be attributed to hepatitis C virus infection.
Liver Unit, Chang Gung Memorial Hospital, Taipei, Taiwan.
C M
CM
Chu
I S
IS
Sheen
Y F
YF
Liaw
D000328:Adult; D000368:Aged; D001483:Base Sequence; D004279:DNA, Viral / Q000032:analysis / Q000235:genetics; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology / Q000502:physiology*; D006506:Hepatitis A / Q000453:epidemiology* / Q000276:immunology / Q000503:physiopathology; D006508:Hepatitis Antibodies / Q000032:analysis / Q000276:immunology; D006509:Hepatitis B / Q000453:epidemiology* / Q000276:immunology / Q000503:physiopathology; D006512:Hepatitis B Core Antigens / Q000032:analysis / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000032:analysis / Q000276:immunology / Q000502:physiology; D006526:Hepatitis C / Q000453:epidemiology* / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis / Q000276:immunology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D012367:RNA, Viral / Q000032:analysis / Q000235:genetics
D004279:DNA, Viral; D006508:Hepatitis Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D007075:Immunoglobulin M; D012367:RNA, Viral