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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
What factors determine the severity of hepatitis A-related acute liver failure?
Journal of Viral Hepatitis, Volume 18, No. 7, Year 2011
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Description
The reason(s) that hepatitis A virus (HAV) infection may progress infrequently to acute liver failure are poorly understood. We examined host and viral factors in 29 consecutive adult patients with HAV-associated acute liver failure enrolled at 10 sites participating in the US ALF Study Group. Eighteen of twenty-four acute liver failure sera were PCR positive while six had no detectable virus. HAV genotype was determined using phylogenetic analysis and the full-length genome sequences of the HAV from a cute liver failure sera were compared to those from self-limited acute HAV cases selected from the CDC database. We found that rates of nucleotide substitution did not vary significantly between the liver failure and non-liver failure cases and there was no significant variation in amino acid sequences between the two groups. Four of 18 HAV isolates were sub-genotype IB, acquired from the same study site over a 3.5-year period. Sub-genotype IB was found more frequently among acute liver failure cases compared to the non-liver failure cases (chi-square test, P < 0.01). At another centre, a mother and her son presented with HAV and liver failure within 1 month of each other. Predictors of spontaneous survival included detectable serum HAV RNA, while age, gender, HAV genotype and nucleotide substitutions were not associated with outcome. The more frequent appearance of rapid viral clearance and its association with poor outcomes in acute liver failure as well as the finding of familial cases imply a possible host genetic predisposition that contributes to a fulminant course. Recurrent cases of the rare sub-genotype IB over several years at a single centre imply a community reservoir of infection and possible increased pathogenicity of certain infrequent viral genotypes. © 2010 Blackwell Publishing Ltd.
Authors & Co-Authors
Ajmera, Veeral H.
United States, Dallas
Ut Southwestern Medical Center
Xia, Guoliang
United States, Atlanta
Centers for Disease Control and Prevention
Vaughan, Gilberto
United States, Atlanta
Centers for Disease Control and Prevention
Forbi, Joseph C.
United States, Atlanta
Centers for Disease Control and Prevention
Ganova-Raeva, Lilia Milkova
United States, Atlanta
Centers for Disease Control and Prevention
Khudyakov, Yury E.
United States, Atlanta
Centers for Disease Control and Prevention
Opio, Christopher Kenneth
United States, Dallas
Ut Southwestern Medical Center
Lee, William Martens
United States, Dallas
Ut Southwestern Medical Center
Statistics
Citations: 58
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1111/j.1365-2893.2010.01410.x
ISSN:
13652893
Research Areas
Genetics And Genomics
Infectious Diseases