title: Non-A, non-B fulminant hepatitis is also non-E and non-C.
abstract: OBJECTIVE
  to define the roles of the hepatitis C and E viruses (HCV and HEV) in non-A, non-B (NANB) fulminant hepatitis.
  
  
  METHODS
  we utilized the polymerase chain reaction to amplify HCV and HEV RNA sequences and assays to detect antibodies to HCV and HEV in the acute phase sera of eight presumed viral NANB and seven nonviral NANB fulminant hepatic failure (FHF) patients.
  
  
  RESULTS
  none of the 15 patients had detectable HCV or HEV RNA or elevated HCV and IgM-HEV antibody titers in their acute phase sera. Three patients, all with features of autoimmune hepatitis, had raised IgG-HEV antibody titers. Due to the possibility of serologically undetectable hepatitis B virus (HBV) infection in fulminant hepatitis patients, we performed polymerase chain reaction amplification of HBV genomic DNA in acute phase sera of the presumed viral NANB FHF patients and subsequently found no evidence of HBV DNA.
  
  
  CONCLUSIONS
  we did not find evidence implicating HCV or HEV in presumed viral NANB FHF or as agents contributing to or causing the liver failure in nonviral NANB FHF patients with autoimmune hepatitis, drug-induced hepatotoxicity, or halothane hepatotoxicity.
authors.affiliation: Mayo Clinic, Division of Gastroenterology, Rochester, Minnesota.
authors.forename: S K
authors.initials: SK
authors.lastname: Kuwada
authors.forename: V M
authors.initials: VM
authors.lastname: Patel
authors.forename: F B
authors.initials: FB
authors.lastname: Hollinger
authors.forename: H J
authors.initials: HJ
authors.lastname: Lin
authors.forename: P O
authors.initials: PO
authors.lastname: Yarbough
authors.forename: R H
authors.initials: RH
authors.lastname: Wiesner
authors.forename: D
authors.initials: D
authors.lastname: Kaese
authors.forename: J
authors.initials: J
authors.lastname: Rakela
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D001327:Autoimmune Diseases / Q000150:complications / Q000276:immunology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D016174:Hepacivirus / Q000276:immunology / Q000302:isolation & purification*; D006501:Hepatic Encephalopathy / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D016752:Hepatitis E virus / Q000276:immunology / Q000302:isolation & purification*; D006525:Hepatitis, Viral, Human / Q000150:complications* / Q000382:microbiology / Q000601:surgery; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis
chemical_list: D000914:Antibodies, Viral; D012367:RNA, Viral