Acute liver failure complicating viral hepatitis A

Introduction: The aetiology of paediatric acute liver failure (PALF) varies widely according to age, and geographic and socioeconomic factors. This study aimed to examine the epidemiology, aetiology and outcome of PALF in Singapore at a single centre. Methods: A retrospective review was performed of patients aged 0–18 years who were diagnosed with PALF from 2007 to 2019. PALF was defined by: absence of chronic liver disease; biochemical evidence of acute liver injury; and coagulopathy, non-correctible by vitamin K, defined as prothrombin time (PT) ≥ 20 seconds or international normalised ratio (INR) ≥ 2.0 regardless of hepatic encephalopathy (HE) or PT ≥ 15 seconds or INR ≥ 1.5 in the presence of HE. Results: 34 patients were included. Median age at diagnosis was 10 months (range 7 days to 156 months). The top three causes of PALF were indeterminate (41.2%), metabolic (26.5%) and infectious (26.5%) aetiologies. A metabolic disorder was the most frequent aetiology in infants < 12 months (38.9%), whereas an indeterminate cause was the most common in children > 12 months (50%). No cases of viral hepatitis A or B presenting with PALF were detected. Overall spontaneous recovery rate (survival without liver transplantation [LT]) was 38.2%, and overall mortality rate was 47.1%. Six patients underwent living-donor LT, and the post-transplant survival at one year was 83.3%. Conclusion: The aetiologic spectrum of PALF in Singapore is similar to that in developed Western countries, with indeterminate aetiology accounting for the majority. PALF is associated with poor overall survival; hence, timely LT for suitable candidates is critical to improve survival outcomes.

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Liver Failure due to Acute Viral Hepatitis (A-E)

Visceral Medicine ◽

10.1159/000444915 ◽

2016 ◽

Vol 32 (2) ◽

pp. 80-85 ◽

Cited By ~ 23

Author(s):

Paul Manka ◽

Jens Verheyen ◽

Guido Gerken ◽

Ali Canbay

Keyword(s):

Liver Failure ◽

Viral Hepatitis ◽

Hepatitis A ◽

Acute Viral Hepatitis ◽

Viral Hepatitis A ◽

Acute Viral Hepatitis A

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Acute Liver Failure due to Hepatitis A Virus

Case Reports in Gastroenterology ◽

10.1159/000514393 ◽

2021 ◽

pp. 927-932

Author(s):

Reem Shammout ◽

Turki Alhassoun ◽

Fadi Rayya

Keyword(s):

Liver Failure ◽

Acute Liver Failure ◽

Viral Hepatitis ◽

Hepatitis A ◽

Hepatitis A Virus ◽

Specific Disease ◽

Hospital Acquired Pneumonia ◽

Hospital Acquired ◽

The Relationship

Acute liver failure (ALF) is a syndrome, rather than a specific disease, with several possible causes, and viral hepatitis is a major cause. The relationship between self-limited and ALF hepatitis A is still poorly understood. A 45-year-old woman presented to our hospital with ALF diagnosis (from another hospital). She suffered from hospital-acquired pneumonia. The patient recovered within 4 weeks and returned to her normal life after 6 months of follow-up.

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Salivary and Serum Biochemical Alterations in Patients with Acute Viral Hepatitis

Revista de Chimie ◽

10.37358/rc.18.3.6191 ◽

2018 ◽

Vol 69 (3) ◽

pp. 747-751 ◽

Cited By ~ 1

Author(s):

Daniela Gabriela Badita ◽

Iulia Ioana Stanescu ◽

Andra Balcangiu Stroescu ◽

Dan Piperea Sianu ◽

Daniela Miricescu ◽

...

Keyword(s):

Viral Hepatitis ◽

Hepatitis A ◽

Hepatitis A Virus ◽

World Population ◽

Major Health Problem ◽

Major Health ◽

Biochemical Alterations ◽

B Virus ◽

Serum Biochemical ◽

Viral Hepatitis A

Viral hepatitis represents a major health problem worldwide. Approximately 1.4 million people are infected with hepatitis A virus every year, although given that most of the cases evolve asymptomatically the real number could be even higher. At the same time, hepatitis B virus affects up to 30% of the world population and represents one of the main causes of cirrhosis and hepatocellular carcinoma. Thus, it is very important to understand the physiopathology of viral hepatitis A and B not only for the diagnosis, but also for the therapeutic protocol. The present research aimed to determine if HAV and HBV can alter serum and salivary levels of total protein and of 2 important electrolytes: calcium and potassium.

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CHRONIC HCV-INFECTION AS A PREDICTOR OF DISEASE SEVERITY (case study)

International Medical Journal ◽

10.37436/2308-5274-2019-3-15 ◽

2020 ◽

pp. 79-82

Author(s):

Nataliia Volodymyrivna Shepylieva ◽

Alla Oleksandrivna Shvaichenko

Keyword(s):

Viral Hepatitis ◽

Hepatitis A ◽

Health Sector ◽

Global Strategy ◽

Hcv Infection ◽

Viral Hepatitis C ◽

Incidence And Mortality ◽

Chronic Hcv Infection ◽

Chronic Hcv ◽

Viral Hepatitis A

A global problem for humanity is the wide spread of HCV carriers worldwide. To address this, the WHO has developed a global strategy for the health sector to eliminate viral hepatitis and has set the following goals: to reduce the number of new cases of chronic hepatitis B and C by 90 % by 2030 as well as to reduce the quantity of death from these infections by 65 %. It is emphasized that the development of infectious or somatic disease on the background of chronic viral hepatitis requires a more careful approach and thorough medical correction, as their course and prognosis can be significantly aggravated. The case of viral hepatitis A, which occurred on a background of previously undiagnosed HCV infection and resulted in a death, has been described. Thus, previously undiagnosed HCV infection exacerbated the course of a self−eliminating disease, such as hepatitis A, and resulted in a death. Therefore, expanding the screening for viral hepatitis will allow identifying infected individuals and conducting antiviral therapy and preventive measures, which will reduce the incidence and mortality rates. Key words: viral hepatitis A, viral hepatitis C, chronic HCV−infection, diagnosis, treatment, outcome.

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Complement System as a Target for Therapies to Control Liver Regeneration/Damage in Acute Liver Failure Induced by Viral Hepatitis

Journal of Immunology Research ◽

10.1155/2018/3917032 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Juliana Gil Melgaço ◽

Carlos Eduardo Veloso ◽

Lúcio Filgueiras Pacheco-Moreira ◽

Claudia Lamarca Vitral ◽

Marcelo Alves Pinto

Keyword(s):

Liver Failure ◽

Acute Liver Failure ◽

Liver Regeneration ◽

Viral Hepatitis ◽

Complement System ◽

Immune Cell ◽

Ex Vivo ◽

Heat Inactivation ◽

Plasma Samples ◽

The Complement System

The complement system plays an important role in innate immunity inducing liver diseases as well as signaling immune cell activation in local inflammation regulating immunomodulatory effects such as liver damage and/or liver regeneration. Our aim is to evaluate the role of complement components in acute liver failure (ALF) caused by viral hepatitis, involving virus-induced ALF in human subjects using peripheral blood, samples of liver tissues, and ex vivo assays. Our findings displayed low levels of C3a in plasma samples with high frequency of C3a, C5a, and C5b/9 deposition in liver parenchyma. Meanwhile, laboratory assays using HepG2 (hepatocyte cell line) showed susceptibility to plasma samples from ALF patients impairing in vitro cell proliferation and an increase in apoptotic events submitting plasma samples to heat inactivation. In summary, our data suggest that the complement system may be involved in liver dysfunction in viral-induced acute liver failure cases using ex vivo assays. In extension to our findings, we provide insights into future studies using animal models for viral-induced ALF, as well as other associated soluble components, which need further investigation.

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