Journal Article

Acute Q Fever Hepatitis in Patients with and without Underlying Hepatitis B or C Virus Infection

Chung-Hsu Lai, Chuen Chin, Hsing-Chun Chung, Chun-Kai Huang, Wei-Fang Chen, Ya-Ting Yang, Wency Chen and Hsi-Hsun Lin

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 45, issue 5, pages e52-e59
Published in print September 2007 | ISSN: 1058-4838
Published online September 2007 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/520680
Acute Q Fever Hepatitis in Patients with and without Underlying Hepatitis B or C Virus Infection

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Background. Although hepatitis is one of the major presentations of acute Q fever, the possible influence of viral hepatitis in Q fever has, to our knowledge, never been investigated. It is an important issue in regions where Q fever hepatitis and viral hepatitis are prevalent, such as Taiwan. We conducted a study to investigate the possible influence of viral hepatitis in cases of acute Q fever hepatitis.

Methods. Cases of acute Q fever confirmed by serologic examination were included in the study. All patients who were found to be positive for Q fever were tested for hepatitis B surface antigen and antibody to hepatitis C virus, and those with positive results had their viral loads determined. Demographic data, clinical manifestations, results of laboratory and imaging examinations, and responses to treatment were recorded retrospectively from charts.

Results. A total of 58 patients with acute Q fever hepatitis were studied, of whom 16 (27.6%) had viral hepatitis (hepatitis B virus infection in 12 and hepatitis C virus infection in 4). Patients with and patients without viral hepatitis did not differ with regard to clinical manifestations and responses to treatment, except that chills (100% vs. 73.8%; P = .02) and nausea and/or vomiting (18.8% vs. 2.4%; P = .03) were significantly more common among patients with viral hepatitis. The change in hepatitis B and C virus loads between the acute and convalescent phase was <1.0 log10.

Conclusions. The clinical manifestations of acute Q fever hepatitis differ little in patients with and patients without underlying viral hepatitis, and replication of hepatitis virus is not influenced by acute Q fever hepatitis.

Journal Article.  3788 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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