title: Hepatitis A as an etiologic agent of acute liver failure in Latin America.
abstract: BACKGROUND
  This prospective, multicenter study examined the importance of hepatitis viruses as etiological agents of acute liver failure (ALF) and the outcome of ALF cases in Latin American children and adolescents.
  
  
  METHODS
  The study was conducted for minimum 12 months in 9 centers in Argentina, Brazil, Chile, Colombia, Costa Rica, and Mexico during 2001-2002. Hospitalized patients aged 1-20 years with a suspected diagnosis of ALF were included in the study and tested for serologic markers for hepatitis A, B, and C viruses.
  
  
  RESULTS
  Of the 106 patients enrolled, 88 were included in the analysis. Median age was 5 years, and 55% with ALF were aged 1-5 years. A total of 37 individuals (43%) tested positive for anti-hepatitis A virus (HAV) immunoglobulin M (IgM) as marker of acute HAV infection; one was positive for anti-hepatitis B core antigen IgM and negative for hepatitis B surface antigen. None had markers of hepatitis C virus infection. Mortality rates in the overall study cohort (45%) and for those who tested anti-HAV IgM positive (41%) were similar. Forty-one percent of all patients and 46% of those positive for anti-HAV IgM underwent transplantation. The mortality rate in those with liver transplantation was half of that in patients who were not transplanted (28% versus 57%).
  
  
  CONCLUSIONS
  HAV was the main etiologic agent of ALF in the population studied.
authors.affiliation: Hospital Nacional de Pediatría Juan P Garrahan, Buenos Aires, Argentina.
authors.forename: Mirta
authors.initials: M
authors.lastname: Ciocca
authors.forename: Sandra Fagundes
authors.initials: SF
authors.lastname: Moreira-Silva
authors.forename: Sylvia
authors.initials: S
authors.lastname: Alegría
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Galoppo
authors.forename: Ricardo
authors.initials: R
authors.lastname: Ruttiman
authors.forename: Gilda
authors.initials: G
authors.lastname: Porta
authors.forename: Themis Reverbel
authors.initials: TR
authors.lastname: Da Silvera
authors.forename: Pilar
authors.initials: P
authors.lastname: Rubio
authors.forename: Mercedes
authors.initials: M
authors.lastname: Macias
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Cervantes
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Avila-Aguero
authors.forename: Sue Anne Costa
authors.initials: SA
authors.lastname: Clemens
authors.forename: Ralf
authors.initials: R
authors.lastname: Clemens
authors.forename: John
authors.initials: J
authors.lastname: Weil
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006506:Hepatitis A / Q000150:complications* / Q000401:mortality; D035922:Hepatitis A Antibodies / Q000097:blood; D006510:Hepatitis B Antibodies / Q000097:blood; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007223:Infant; D007843:Latin America; D017114:Liver Failure, Acute / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D016031:Liver Transplantation; D008297:Male; D015995:Prevalence; D011446:Prospective Studies
chemical_list: D035922:Hepatitis A Antibodies; D006510:Hepatitis B Antibodies; D018937:Hepatitis C Antibodies; D007075:Immunoglobulin M