Prolonged and biphasic acute hepatitis A in hepatitis B virus carrier

Submitted: 8 December 2014
Accepted: 12 February 2016
Published: 5 April 2016
Abstract Views: 1361
PDF: 908
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Acute hepatitis A is generally a self-limited disease in healthy subjects within few weeks, but an uncommon type of prolonged and biphasic acute course of hepatitis A infection has been also described. This type of presentation is observed in about 6-10% of patients, but a small number of reports, concerning this topic, are available in literature. In addition, hepatitis A virus (HAV) infection in hepatitis B virus (HBV) carriers has rarely been discussed. A 41-year-old Italian man, already known to our Department for HBV infection as an inactive carrier HBsAg(+)ve, experienced a prolonged and biphasic course of acute hepatitis A, lasting about 7 months. In this patient possible factors, causing the second flare of transaminases, were excluded (in particular autoimmunity). Liver biopsy as well HAV RNA search in blood/stools were not performed. In conclusion, the hepatologist should take into account this type of atypical course in patients with HAV-related hepatitis and should promote HAV vaccination in subjects with HBV-chronic hepatitis, to prevent possible life-threatening acute exacerbation of hepatic damage, mainly in HBV-carriers with more severe forms of liver diseases.

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Garlatti Costa, E., Ghersetti, M., Grazioli, S., & Casarin, P. (2016). Prolonged and biphasic acute hepatitis A in hepatitis B virus carrier. Italian Journal of Medicine, 10(3), 241–244. https://doi.org/10.4081/itjm.2016.571

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