title: Fulminant hepatitis failure in adults and children from a Public Hospital in Rio de Janeiro, Brazil.
abstract: Fulminant hepatic failure (FHF) is characterized by massive hepatocellular injury, whose physiopathology is still unclear. Hepatitis B (HBV) is probably the most common viral cause of FHF, while hepatitis A (HAV) virus seem occurs less frequently. However, the host and viral factors that determine the outcome of these infections are poorly understood. In the present study, viral load and genotyping determining regions of HAV and HBV genomes were sequenced. Eight FHF patients and one patient with severe acute hepatitis (SAH) were included. Liver and blood samples were collected during liver transplantation or necropsy procedures. HAV-RNA and HBV-DNA were extracted from serum, biopsy and paraffin liver. Nucleotide sequencing of HAV-RNA was performed from VP1/2A and HBV-DNA from PreS/S region. The amplified samples were quantified by Real-Time PCR. The cases of HAV infection were due to subgenotype IA. The cases of HBV infection were due to genotype A2 and D4. The case of HAV/HBV coinfection was infected by genotype IA and D3. Hepatitis A and B infection were associated with genotypes most prevalent in Brazil. In hepatitis A infection the mean of period evolution was 13 days. In hepatitis B, FHF patients infected by genotype D have a shorter period of evolution than FHF patients infected by genotype A (mean 15 v. 53 days). There was no association with genotype-determining region with the severity of hepatitis, however nucleotide differences and high viral load could be observed among FHF.
authors.affiliation: Laboratório de Desenvolvimento Tecnológico em Virologia, IOC, FIOCRUZ, Rio de Janeiro, RJ, Brazil.
authors.forename: Damião Carlos Moraes dos
authors.initials: DC
authors.lastname: Santos
authors.forename: José Manoel da Silva Gomes
authors.initials: JM
authors.lastname: Martinho
authors.forename: Lucio Filgueiras
authors.initials: LF
authors.lastname: Pacheco-Moreira
authors.forename: Cristina Carvalho Viana de
authors.initials: CC
authors.lastname: Araújo
authors.forename: Barbara Cristina Euzebio Pereira Dias de
authors.initials: BC
authors.lastname: Oliveira
authors.forename: Barbara Vieira
authors.initials: BV
authors.lastname: Lago
authors.forename: Marcelo Alves
authors.initials: MA
authors.lastname: Pinto
authors.forename: Vanessa Salete de
authors.initials: VS
authors.lastname: Paula
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001483:Base Sequence; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005838:Genotype; D006506:Hepatitis A / Q000150:complications / Q000821:virology*; D017957:Hepatitis A Virus, Human / Q000235:genetics* / Q000276:immunology; D006509:Hepatitis B / Q000150:complications / Q000821:virology*; D006515:Hepatitis B virus / Q000235:genetics* / Q000276:immunology; D006801:Humans; D017114:Liver Failure, Acute / Q000821:virology*; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009154:Mutation; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D019562:Viral Load
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral