Acute hepatitis with severe cholestasis and prolonged clinical course due to hepatitis A virus Ia and Ib coinfection.
BACKGROUND
Acute viral hepatitis due to hepatitis A virus is a self-limited illness that infrequently has a severe clinical course.


METHODS
We analyzed the virological characteristics of acute hepatitis A in a patient with a severe clinical presentation (peak total and conjugated bilirubin levels, 65.5 mg/dL and 40.1 mg/dL, respectively) and a course of disease that lasted 7 months.


RESULTS
Hepatitis A virus sequencing revealed coinfection with 2 subgenotypes of hepatitis A virus (Ia and Ib) as etiological factors of the illness.


CONCLUSIONS
Hepatitis A virus Ia and Ib coinfection may have accounted for the prolonged and severe course of illness.
Coppola
Nicola
N
Department of Public Medicine, Section of Infectious Diseases, Second University of Naples, Naples, Italy.
Genovese
Domenico
D
Pisaturo
Mariantonietta
M
Taffon
Stefania
S
Argentini
Claudio
C
Pasquale
Giuseppe
G
Sagnelli
Caterina
C
Piccinino
Felice
F
Rapicetta
Maria
M
Sagnelli
Evangelista
E
D000208:Acute Disease; D000328:Adult; D000595:Amino Acid Sequence; D001483:Base Sequence; D002779:Cholestasis / Q000473:pathology / Q000503:physiopathology* / Q000821:virology*; D005838:Genotype; D006506:Hepatitis A / Q000150:complications* / Q000821:virology*; D030041:Hepatitis A virus / Q000235:genetics*; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D012720:Severity of Illness Index