Influence of load of hepatitis A virus on disease severity and its relationship with clinical manifestations in patients with hepatitis A.
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.
Sainokami
Shigehiko
S
First Department of Internal Medicine, Iwate Medical University, Iwate, Japan. sainokami@mizhsp-iwate.jp
Abe
Koichi
K
Ishikawa
Kazuyoshi
K
Suzuki
Kazuyuki
K
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
D012367:RNA, Viral; D002097:C-Reactive Protein; D000410:Alanine Transaminase