Fulminant hepatitis A in patients with chronic liver disease.
Fulminant hepatitis is a rare complication of acute hepatitis A virus (HAV) infection. We report three cases of fulminant hepatic failure with death due to HAV infection in patients with pre-existing chronic liver disease. Data from the literature also indicate a high case fatality rate during HAV superinfection in patients with chronic hepatitis B, particularly those with cirrhosis, and in patients with alcoholic cirrhosis. In patients with chronic hepatitis C, results are conflicting with some reports indicating a high fatality rate of HAV superinfection and others not, irrespective of the presence or absence of cirrhosis. Based on our observations and this review of the literature, we suggest that patients with chronic liver disease should be vaccinated against hepatitis A.
Division of Hepatology, Centre Hospitalier Universitaire de Montréal, Québec.
P
P
Lefilliatre
J P
JP
Villeneuve
D000328:Adult; D002170:Canada / Q000453:epidemiology; D002908:Chronic Disease; D005260:Female; D006506:Hepatitis A / Q000150:complications*; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000150:complications; D017093:Liver Failure / Q000209:etiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D014611:Vaccination; D014761:Viral Hepatitis Vaccines / Q000627:therapeutic use
D014761:Viral Hepatitis Vaccines