Do high levels of viral replication contribute to fulminant hepatitis A?


Osamu Yokosuka, MD, First Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
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Abstract: Background: The possible correlation between the severity of hepatitis A and the levels of viral replication has not been established.

Methods: We investigated the level of viral replication in sera from 31 patients with sporadic hepatitis A, comprising six patients with fulminant hepatitis, five with severe acute hepatitis, and 20 with acute hepatitis using reverse transcription-polymerase chain reaction (PCR) and a multi-cyclic PCR method.

Results: The hepatitis A virus RNA level was higher in fulminant hepatitis than in acute hepatitis (P=0.003).

Conclusion: We believe that this higher viral load in patients with fulminant and severe hepatitis A may be associated with the pathogenesis of disease severity.