560 DIAGNOSTIC ACCURACY OF MULTIPLEX REAL-TIME PCR TEST KIT FOR DIAGNOSIS OF ACUTE HEPATITIS A AND CHRONIC HEPATITIS B AND CHRONIC HEPATITIS C

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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Acute Hepatitis A Outbreak Among Men Who Have Sex With Men in Krakow, Poland; February 2017–February 2018

American Journal of Men s Health ◽

10.1177/1557988319895141 ◽

2019 ◽

Vol 13 (6) ◽

pp. 155798831989514 ◽

Cited By ~ 4

Author(s):

Aleksandra Raczyńska ◽

Nimmi Nimesha Wickramasuriya ◽

Anna Kalinowska-Nowak ◽

Aleksander Garlicki ◽

Monika Bociąga-Jasik

Keyword(s):

Chronic Hepatitis ◽

Acute Hepatitis ◽

Hepatitis A ◽

Clinical Manifestations ◽

Sexually Transmitted ◽

Acute Retroviral Syndrome ◽

Chronic Hepatitis B Virus ◽

Route Of Transmission ◽

Acute Hepatitis A ◽

Sex With Men

Since February 2017 in Poland, an increasing number of acute hepatitis A (AHA) cases have been reported; a noteworthy increase to 3,072 cases of AHA in 2017 compared to 35 cases in 2016 was reported by the National Institute of Public Health (NIPH). The aim of this study was to evaluate the demographic features, clinical manifestations, laboratory results, and sexually transmitted coinfections. All cases of AHA diagnosed between February 2017 and February 2018 at the University Hospital in Krakow were analyzed. A total of 119 cases of hepatitis A virus (HAV) were reported; 105 (88%) were males and 14 (12%) were females, with a mean age 31 years (range 19–62). In 84 patients (71%), the HAV was transmitted by oral–anal sexual contact between men. Six women were infected by close house contact with men infected with HAV. The route of transmission was not identified for 29 cases, and 88 patients (74%) required hospitalization. Among the cases, the following coinfections were already diagnosed: HIV 36 patients (30%), chronic hepatitis C virus (HCV) 4 patients (3%), and chronic hepatitis B virus (HBV) 2 patients (1.5%). During AHA diagnosis, some new sexually transmitted infections (STIs) were detected; syphilis eight patients (6.7%), HIV/syphilis seven patients (6%), HIV//HCV/syphilis one patient, and acute retroviral syndrome/ Shigella flexneri one patient. Overall, AHA outbreak in Poland in 2017 affected primarily men who have sex with men (MSM) and was connected with oral–anal sexual contacts, and the majority of patients did not have HAV vaccination. These results show a clear need for routinely offering HAV vaccination to at-risk populations and that awareness among health-care workers about HAV sexual transmission may help introduce prevention methods.

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