Skip to main content

Advertisement

SpringerLink
Log in

Epidemiological, clinical and biological characteristics of acute non-A, non-B hepatitis with and without hepatitis C virus infection

Epidemiologische, klinische und biologische Charakteristika der akuten Non-A-, Non-B-Hepatitis mit und ohne Beteiligung des Hepatitis C Virus

  • Originalia
  • Published:
Infection Aims and scope Submit manuscript

Summary

Serially collected serum samples from 81 patients with acute non-A, non-B hepatitis were tested for the presence of antibodies to hepatitis C virus (anti-HCV) by a second-generation enzyme immunoassay (EIA) test. Anti-HCV was detected in 56 cases (69%) during the first month, in 61 cases (75%) at 3 months and in 63 cases (78%) at 6 months. In those 18 patients showing anti-HCV negative results in the three determinations, hepatitis C virus (HCV) RNA was tested using a nested polymerase chain reaction (PCR) in the first serum sample and was detected in only one case. Anti-HCV or HCV-RNA positive episodes were considered as acute hepatitis C, while those negative for both markers were classified as acute non-A, non-B, non-C hepatitis. On comparing acute hepatitis C with the non-A, non-B, non-C episodes, no significant differences were found in the presence of jaundice, mean maximum alanine-aminotransferase (ALT) levels and positivity of markers of past hepatitis B virus (HBV) infection. However, patients with hepatitis C were significantly younger than those with non-A, non-B, non-C hepatitis (p=0.002). Male sex (78.1% vs. 35.3%; p=0.001), history of parenteral exposure (90.6% vs. 11.8%; p=0.0001), and progression to chronicity (73.4% vs. 5.9%; p=0.0001) were significantly more frequent in the HCV-related group. Although other possibilities cannot be excluded, these results suggest that there might be a different infectious agent implicated in the etiology of acute non-A, non-B, non-C hepatitis. This unidentified agent appears to be transmitted by the parenteral route with a lower frequency than HCV and to be responsible for acute hepatitis with a severity similar to that of acute hepatitis C but with a lower chronicity rate.

Zusammenfassung

Serielle Serumproben von 81 Patienten mit akuter Non-A-, Non-B-Hepatitis wurden mit einem Enzym-Immunassay (EIA) der zweiten Generation auf Antikörper gegen das Hepatitis C Virus (anti-HCV) getestet. Im ersten Monat waren 65 Fälle (69%) anti-HCV positiv, in 61 Fällen (75%) nach 3 Monaten und in 63 Fällen (78%) nach 6 Monaten. Bei 18 Fällen mit negativen Testergebnissen bei allen drei Terminen wurde Hepatitis C Virus (HCV) RNA mittels geschachtelter PCR in der ersten Serumprobe nur in einem Fall gefunden. Anti-HCV oder HCV-RNA positive Fälle wurden als akute Hepatitis C klassifiziert. Fälle, die bei beiden Testverfahren negativ blieben, als akute Non-A-, Non-B-Hepatitis. Diese beiden Kategorien unterschieden sich nicht signifikant hinsichtlich des Auftretens von Ikterus, maximalen ALT-Spiegeln und positivem Testausfall für zurückliegende Infektionen mit dem Hepatitis B Virus (HBV). Patienten mit Hepatitis C waren jedoch signifikant jünger als Patienten mit Non-A-, Non-B-Hepatitis (p=0,002). Männliches Geschlecht war ebenso häufiger (78,1% vs. 35,3%; p=0,001) wie Vorgeschichte parenteraler Exposition (90,6% vs. 11,8%; p=0,0001) und Progression zur Chronizität (73,4% vs. 5,9%; p=0,0001) in der durch HCV infizierten Gruppe. Möglicherweise ist in der Ätiologie der Non-A-, Non-B-Hepatitis ein weiteres infektiöses Agens involviert, obwohl sich andere Möglichkeiten nicht ausschließen lassen. Der unbekannte Erreger scheint seltener parenteral übertragen zu werden als HCV und für eine akute Hepatitis verantwortlich zu sein, die in ihrem Schweregrad der akuten Hepatitis C ähnlich ist, aber seltener einen chronischen Verlauf nimmt.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Choo, Q.-L., Kuo, G., Weiner, A. J., Overby, L. R., Bradley, D. W., Houghton, M. Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science 244 (1989) 359–362.

    Google Scholar 

  2. Kuo, G., Choo, Q.-L., Alter, H. J., Gitnick, G. L., Redeker, A. G., Purcell, R. H., Miyamura, T., Dienstag, J. L., Alter, M. J., Stevens, C., Tegtmeier, G. E., Bonino, F., Colombo, M., Lee, W. S., Kuo, C., Berger, K., Shuster, J. R., Overby, L. R., Bradley, D. W., Houghton, M. An assay for circulating antibodies to a major etiologic virus of human non-A, non-B viral hepatitis genome. Science 244 (1989) 362–364.

    Google Scholar 

  3. Alter, H. J., Purcell, R. H., Shih, J. W., Melpolder, J. C., Houghton, M., Choo, Q.-L., Kuo, G. Detection of antibody to hepatitis C virus in prospectively followed transfusion recipients with acute and chronic non-A, non-B hepatitis. N. Engl. J. Med. 321 (1989) 1494–1500.

    Google Scholar 

  4. McHutchison, J. G., Kuo, G., Houghton, M., Choo, Q.-L., Redeker, A. G. Hepatitis C virus antibodies in acute icteric and chronic non-A, non-B hepatitis. Gastroenterology 101 (1991) 1117–1119.

    Google Scholar 

  5. Bortolotti, F., Tagger, A., Cadrobbi, P., Crivellaro, C., Pregliasco, F., Ribero, M. L., Alberti, A. Antibodies to hepatitis C virus in community-acquired acute non-A, non-B hepatitis. J. Hepatol. 12 (1991) 176–179.

    Google Scholar 

  6. McHutchison, J. G., Person, L., Govindarajan, S., Valinluck, B., Gore, T., Lee, S. R., Nelles, M., Polito, A., Chien, D., DiNello, R., Quan, S., Kuo, G., Redeker, A. G. Improved detection of hepatitis C virus antibodies in high-risk populations. Hepatology 15 (1992) 19–25.

    Google Scholar 

  7. Brown, J., Dourakis, S., Karayiannis, P., Goldin, R., Chiba, J., Ohba, H., Miyamura, T., Thomas, H. C. Seroprevalence of hepatitis C virus nucleocapsid antibodies in patients with cryptogenetic chronic liver disease. Hepatology 15 (1992) 175–179.

    Google Scholar 

  8. Jeffers, L. J., Hasan, F., De Medina, M., Reddy, R., Parker, T., Silva, M., Mendez, L., Schiff, E. R., Manns, M., Houghton, M., Choo, Q.-L., Kuo, G. Prevalence of antibodies to hepatitis C virus among patients with cryptogenetic chronic hepatitis and cirrhosis. Hepatology 15 (1992) 187–190.

    Google Scholar 

  9. Alter, M. J., Margolis, H. S., Krawczynski, K., Judson, F. N., Mares, A., Alexander, W. J., Hu, P. Y., Miller, J. K., Gerber, M. A., Sampliner, R. E., Meeks, E. L., Beach, M. J. The natural history of community-acquired hepatitis C in the United States. N. Engl. J. Med. 327 (1992) 1899–1905.

    Google Scholar 

  10. Porchon, C., Kremsdorf, D., Pol, S., Lunel-Fabianni, F., Driss, F., Opolon, P., Berthelot, P., Brechot, C. Serum hepatitis C virus RNA and hepatitis B virus DNA in non-A, non-B post-transfusional and sporadic chronic hepatitis. J. Hepatol. 16 (1992) 184–189.

    Google Scholar 

  11. Bianchi, L., De Groote, J., Desmet, V. J., Gedigk, P., Korb, G., Popper, H., Poulsen, H., Scheuer, P. J., Schmid, M., Thaler, H., Wepler, W. Acute and chronic hepatitis revisited. Lancet ii (1977) 914–919.

    Google Scholar 

  12. Tateda, A., Kikuchi, K., Numazaki, Y., Shirachi, R., Ishida, N. Non-B hepatitis in Japanese recipients of blood transfusions: clinical and serologic studies after the introduction of laboratory screening of blood donors for hepatitis B surface antigen. J. Infect. Dis. 139 (1979) 511–518.

    Google Scholar 

  13. Rodríguez, M., Rodrigo, L., Tévar, F. Second-generation tests for hepatitis C virus. Ann. Intern. Med. 115 (1991) 747.

    Google Scholar 

  14. Weiner, A. J., Kuo, G., Bradley, D. W., Bonino, F., Saracco, G., Lee, C., Rosenblatt, J., Choo, Q.-L., Houghton, M. Detection of hepatitis C viral sequences in non A, non B hepatitis. Lancet 35 (1990) 1–3.

    Google Scholar 

  15. Sakamoto, N., Sato, C., Haritani, H., Maekawa, S., Kurosaki, M., Enomoto, N., Hoshino, Y., Tazawa, J., Nishimura, M., Marumo, F. Detection of hepatitis C viral RNA in sporadic acute non-A, non-B hepatitis by polymerase chain reaction. J. Hepatol. 17 (1993) 28–33.

    Google Scholar 

  16. Wang, J. T., Wang, T. H., Sheu, J. C., Lin, J. T., Wang, C. Y., Chen, D. S. Posttransfusion hepatitis revisited by hepatitis C antibody assays and polymerase chain reaction. Gastroenterology 103 (1992) 609–616.

    Google Scholar 

  17. Koretz, R. L., Brezina, M., Polito, A. J., Quan, S., Wilber, J., Dinello, R., Gitnick, G. Non-A, non-B posttransfusion hepatitis: comparing C and non-C hepatitis. Hepatology 17 (1993) 361–365.

    Google Scholar 

  18. Liang, T. J., Jeffers, L., Reddy, R. K., Silva, M. O., Cheinequer, H., Findor, A., De Medina, M., Yarbough, P. O., Reyes, G. R., Schiff, E. R. Fulminant or subfulminant non-A, non-B viral hepatitis: the role of hepatitis C and E viruses. Gastroenterology 104 (1993) 556–562.

    Google Scholar 

  19. Zaaijer, H. L., Cuypers, H. T. M., Reesink, H. W., Winkel, I. N., Gerken, G., Lelie, P. N. Reliability of polymerase chain reaction for detection of hepatitis C virus. Lancet 341 (1993) 722–724.

    Google Scholar 

  20. Sallie, R., Tibbs, C., Silva, A. E., Sheron, N., Eddelston, A., Williams, R.: Detection of hepatitis “E” but not “C” in sera of patients with fulminant NANB hepatitis. Hepatology 14 (1991) 68A.

  21. Bradley, D. W., Krawcynski, K., Beach, M. J., Purdy, M. A. Non-A, non-B hepatitis: toward the discovery of hepatitis C and E virus. Sem. Liv. Dis. 11 (1991) 128–146.

    Google Scholar 

  22. Bréchot, C., Degos, F., Lugassy, C., Thiers, V., Zafrani, S., Franco, D., Bismuth, H., Trépo, C., Benhamou, J. P., Wands, J., Isselbacher, K., Tiollais, P., Berthelot, P. Hepatitis B virus DNA in patients with chronic liver disease and negative tests for hepatitis B surface antigen. N. Engl. J. Med. 312 (1985) 270–276.

    Google Scholar 

  23. Tassopoulos, N., Hatzakis, A., Delladetsima, I., Koutelou, M. G., Todoulos, A., Miriagou, V. Role of hepatitis C virus in acute non-A, non-B hepatitis in Greece: A 5-year prospective study. Gastroenterology 102 (1992) 969–972.

    Google Scholar 

  24. Féray, C., Gigou, M., Samuel, D., Reyes, G., Bernuau, J., Reynes, M., Bismuth, H., Bréchot, C. Hepatitis C virus RNA and hepatitis B virus DNA in serum and liver of patients with fulminant hepatitis. Gastroenterology 104 (1993) 549–555.

    Google Scholar 

  25. Krogsgaard, K., Wantzin, P., Mathiesen, L. R., Sonne, J., Ring-Larsen, H., The Copenhagen Hepatitis Acute Programme Early appearance of antibodies to hepatitis C virus in community acquired non-A, non-B hepatitis is associated with progression to chronic liver disease. Scand. J. Infect. Dis. 22 (1990) 399–402.

    Google Scholar 

  26. Tanaka, E., Kiyosawa, K., Sodeyama, T., Nakano, Y., Yoshizawa, K., Hayata, T., Shimizu, S., Nakatsuji, Y., Koike, Y., Furuta, S. Significance of antibody to hepatitis C virus in Japanese patients with viral hepatitis: relationship between anti-HCV antibody and the prognosis of non-A, non-B posttransfusion hepatitis. J. Med. Virol. 33 (1991) 117–122.

    Google Scholar 

  27. Wang, T. H., Wang, J. T., Lin, J. T., Sheu, J. C., Sung, J. L., Chen, D. S. A prospective study of posttransfusion hepatitis in Taiwan. J. Hepatol. 13 (1991) 38–43.

    Google Scholar 

  28. Feinman, S. V., Berris, B., Herst, R. Anti-HCV in post-transfusion hepatitis: deductions from a prospective study. J. Hepatol. 12 (1991) 377–381.

    Google Scholar 

  29. Alter, H. J., Jett, B. W., Polito, A. J., Farci, P., Melpoder, J. C., Shihj, J. W., Shimizu, Y., Purcell, R. Analysis of the role of hepatitis C virus in transfusion-associated hepatitis. In:Hollinger, F. B., Lemon, S. M., Margolis, H. (eds.): Viral hepatitis and liver disease. Williams and Wilkins, Baltimore 1991, pp. 396–402.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Gastroenterology Unit, Hospital Central de Asturias, Celestino Villamil s/n, E-33006, Oviedo, Spain

    C. A. Navascués M. D.,  M. Rodríguez M. D., N. G. Sotorrío M. D., R. Pérez M. D., Ph. D., J. de la Vega M. D. & L. Rodrigo M. D., Ph. D.

  2. Microbiology Unit, Hospital Central de Asturias, Celestino Villamil s/n, E-33006, Oviedo, Spain

    P. Leiva M. D. & A. Martínez M. D.

Authors
  1. C. A. Navascués M. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Rodríguez M. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N. G. Sotorrío M. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Leiva M. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Martínez M. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R. Pérez M. D., Ph. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. de la Vega M. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. L. Rodrigo M. D., Ph. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Navascués, C.A., Rodríguez, M., Sotorrío, N.G. et al. Epidemiological, clinical and biological characteristics of acute non-A, non-B hepatitis with and without hepatitis C virus infection. Infection 22, 252–257 (1994). https://doi.org/10.1007/BF01739909

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01739909

Keywords

Search

Navigation