Acute Q fever hepatitis in patients with and without underlying hepatitis B or C virus infection.
BACKGROUND
Although hepatitis is one of the major presentations of acute Q fever, the possible influence of viral hepatitis in Q fever has, to our knowledge, never been investigated. It is an important issue in regions where Q fever hepatitis and viral hepatitis are prevalent, such as Taiwan. We conducted a study to investigate the possible influence of viral hepatitis in cases of acute Q fever hepatitis.


METHODS
Cases of acute Q fever confirmed by serologic examination were included in the study. All patients who were found to be positive for Q fever were tested for hepatitis B surface antigen and antibody to hepatitis C virus, and those with positive results had their viral loads determined. Demographic data, clinical manifestations, results of laboratory and imaging examinations, and responses to treatment were recorded retrospectively from charts.


RESULTS
A total of 58 patients with acute Q fever hepatitis were studied, of whom 16 (27.6%) had viral hepatitis (hepatitis B virus infection in 12 and hepatitis C virus infection in 4). Patients with and patients without viral hepatitis did not differ with regard to clinical manifestations and responses to treatment, except that chills (100% vs. 73.8%; P=.02) and nausea and/or vomiting (18.8% vs. 2.4%; P=.03) were significantly more common among patients with viral hepatitis. The change in hepatitis B and C virus loads between the acute and convalescent phase was <1.0 log(10).


CONCLUSIONS
The clinical manifestations of acute Q fever hepatitis differ little in patients with and patients without underlying viral hepatitis, and replication of hepatitis virus is not influenced by acute Q fever hepatitis.
Section of Infectious Diseases, Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung County, Taiwan, Republic of China.
Chung-Hsu
CH
Lai
Chuen
C
Chin
Hsing-Chun
HC
Chung
Chun-Kai
CK
Huang
Wei-Fang
WF
Chen
Ya-Ting
YT
Yang
Wency
W
Chen
Hsi-Hsun
HH
Lin
D000208:Acute Disease; D000328:Adult; D002681:China; D005260:Female; D005334:Fever; D016174:Hepacivirus / Q000472:pathogenicity; D006509:Hepatitis B / Q000150:complications*; D006515:Hepatitis B virus / Q000472:pathogenicity; D006526:Hepatitis C / Q000150:complications*; D006529:Hepatomegaly; D006801:Humans; D008297:Male; D008875:Middle Aged; D011778:Q Fever / Q000150:complications* / Q000503:physiopathology; D013163:Splenomegaly; D019562:Viral Load; D014779:Virus Replication