Clinical Study of Acute Type a Viral Hepatitis in Hepatitis B Surface Antigen Carriers and Non-Carriers

乙型肝炎帶原者及非帶原者併發急性甲型肝炎之臨床研究

謝忠平(Jong-Pyng Hsieh) ； 唐鴻舜(Hung-Shung Tang) ； 趙有誠(You-Chen Chao) ； 謝財源(Tsai-Yuan Hsieh) ； 許重得(Chung-Te Hsu) ； 吳國良(Guo-Liang Wu)

《中華民國消化系醫學會雜誌》 9卷1期 (1992/03) Pp. 22-28

https://doi.org/10.6557/GJTa.199203_9(1).0004

摘要

According to past epidemiological. investigation, more than 90% of adults in Taiwan had type A viral hepatitis. However, a decline in the positive rate of anti-HAV in adults was also found in recent years. Therefore, HAV infection is still a problem in our area. Type B viral hepatitis is endemic to Taiwan with a HBV carrier rate of 15-20%. The main purpose of this study is to discover whether or not the clinical and biochemical pictures are different when the HBs Ag carriers superinfect with an acute type A viral hepatitis. Sixty-one cases with acute type A viral hepatitis were analyzed from 1981 to 1990 at Tri-Service General Hospital. The diagnostic criteria of acute type A viral hepatitis were confirmed by positive 1gM-anti-HA V. There were 35 males and 26 females, aged from 4 to 73 years old. The peak age ranged from 16 to 25 years. Among these 61 cases, 50 cases (81.9%) were HBs Ag negative, 11 cases (18.1%) were HBs Ag positive, an incidence similiar to that in the general population of Taiwan. Their clinical and biochemical pictures were identical with the HBs Ag negative patients except for a significant elevation of AST, ALT, and total bilirubin in HBs Ag non-carriers (P＜0.01 and ＜0.05). This indicates that HBs Ag negative patients had more severe damage of liver cells but their hepatic recovery is rather faster than those of HBs Ag positive patients. No evidence of continued inflammation or chronic hepatitis was demonstrated in the follow-up study.

關鍵字

甲型病毒肝炎 ； 乙型病毒肝炎 ； HBs Ag ； 急性病毒肝炎 ； IgM-anti-HAV

並列摘要

According to past epidemiological. investigation, more than 90% of adults in Taiwan had type A viral hepatitis. However, a decline in the positive rate of anti-HAV in adults was also found in recent years. Therefore, HAV infection is still a problem in our area. Type B viral hepatitis is endemic to Taiwan with a HBV carrier rate of 15-20%. The main purpose of this study is to discover whether or not the clinical and biochemical pictures are different when the HBs Ag carriers superinfect with an acute type A viral hepatitis. Sixty-one cases with acute type A viral hepatitis were analyzed from 1981 to 1990 at Tri-Service General Hospital. The diagnostic criteria of acute type A viral hepatitis were confirmed by positive 1gM-anti-HA V. There were 35 males and 26 females, aged from 4 to 73 years old. The peak age ranged from 16 to 25 years. Among these 61 cases, 50 cases (81.9%) were HBs Ag negative, 11 cases (18.1%) were HBs Ag positive, an incidence similiar to that in the general population of Taiwan. Their clinical and biochemical pictures were identical with the HBs Ag negative patients except for a significant elevation of AST, ALT, and total bilirubin in HBs Ag non-carriers (P＜0.01 and ＜0.05). This indicates that HBs Ag negative patients had more severe damage of liver cells but their hepatic recovery is rather faster than those of HBs Ag positive patients. No evidence of continued inflammation or chronic hepatitis was demonstrated in the follow-up study.

並列關鍵字

HAV ； HBV ； HBs Ag ； acrte viral hepatitis ； IgM-anti-HAV