MARIA H. SJOGREN, M.D.; HUGO TANNO, M.D.; OSCAR FAY, Ph.D.; SANTOS SILEONI, Ph.D.; BARRY D. COHEN, B.A.; DONALD S. BURKE, M.D.; ROBERT J. FEIGHNY, Ph.D.
Among 256 patients with acute hepatitis A, 17 (6.6%) had a relapse of the disease between 30 and 90 days after the primary episode. We studied 7 of these patients. Serologic testing showed mean alanine aminotransferase levels of 1668 IU/L during the acute stage, 107 IU/L during the early convalescence, and 1027 IU/L during the relapse. Tests for IgM antibody against hepatitis A virus were positive in the 7 patients at the onset of disease, with decreasing levels in 3 of the 4 patients tested during the evolution of the illness. Stools collected during the relapse phase showed hepatitis A virus by immune electron microscopy, radioimmunoassay, and molecular hybridization using a 32P-labeled cDNA-hepatitis A virus probe. Stools collected from 4 of these patients 6 to 12 months after the onset of disease were negative for the virus. The finding of hepatitis A virus in the stool of these patients during the relapse phase strongly implicates hepatitis A virus as the causative agent of the clinical relapse.
SJOGREN MH, TANNO H, FAY O, SILEONI S, COHEN BD, BURKE DS, et al. Hepatitis A Virus in Stool During Clinical Relapse. Ann Intern Med. ;106:221–226. doi: 10.7326/0003-4819-106-2-221
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Published: Ann Intern Med. 1987;106(2):221-226.
Gastroenterology/Hepatology, Infectious Disease, Viral Hepatitis.
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