title: Influence of load of hepatitis A virus on disease severity and its relationship with clinical manifestations in patients with hepatitis A.
abstract: OBJECTIVE
  The purpose of the present study was to investigate the influence of viral load on disease severity and analyze the possible relationship of the load of hepatitis A virus (HAV) with disease severity and laboratory findings.
  
  
  METHODS
  Fifty-eight patients diagnosed with acute hepatitis A were used in the current study, of whom 12 patients progressed to severe acute hepatitis (s-AH) defined on the basis of a prothrombin time (PT) of <40% and 46 patients were diagnosed as having mild acute hepatitis (m-AH). The load of HAV was measured with real-time polymerase chain reaction.
  
  
  RESULTS
  Peak viral load showed a significant correlation with alanine aminotransferase (ALT) (r = 0.363, P = 0.0048) and PT levels (r = -0.330, P = 0.0110). In terms of disease severity, there was a significant correlation with ALT (r = 0.462, P = 0.0012) and PT levels (r = 0.400, P = 0.0059) in the m-AH group, but not in the s-AH group. A significant positive correlation of peak viral load with the C-reactive protein level (r = 0.270, P = 0.0400) and a significant negative correlation of peak viral load with the platelet count (r = -0.313, P = 0.0015) was also found.
  
  
  CONCLUSIONS
  The load of HAV was closely correlated with liver damage and disease severity in m-AH, but not in s-AH. The load of HAV was also closely associated with the increase in C-reactive protein level and enhancement of thrombocytopenia.
authors.affiliation: First Department of Internal Medicine, Iwate Medical University, Iwate, Japan. sainokami@mizhsp-iwate.jp
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Sainokami
authors.forename: Koichi
authors.initials: K
authors.lastname: Abe
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Ishikawa
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Suzuki
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001772:Blood Cell Count; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006506:Hepatitis A / Q000097:blood / Q000473:pathology / Q000821:virology*; D017957:Hepatitis A Virus, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011517:Prothrombin Time; D012367:RNA, Viral / Q000097:blood; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000150:complications; D019562:Viral Load
chemical_list: D012367:RNA, Viral; D002097:C-Reactive Protein; D000410:Alanine Transaminase