Viral etiology and assessment of HBV genotypes in Fulminant Hepatic Failure: the present scenario
Keywords:
fulminant hepatic failure, Genotype D, HAV, HCV, HEV, Viral hepatitis,
Abstract
Background: Fulminant hepatic failure (FHF) is defined as the rapid development of acute liver injury with severe impairment of synthetic functions and hepatic encephalopathy in patients without obvious previous liver disease. The present study was carried out to evaluate the etiology of FHF on one hand and to assess the role of HBV genotypes in acute liver failure in India on the other hand.Methods: The patients who developed fulminant hepatic failure (FHF) were screened for HAV, HBV, HCV, HEV and HIV and Hepatitis B Core IgM, HBeAg, anti-HBs and anti-HBe were assessed. HBV genotyping was performed using Kirschberg’s type specific primers (TSP-PCR), heminested PCR, and Naito’s monoplex PCR. SEN and TTV viruses were detected in Non-A to Non-E hepatitis (NANEH).Results: Majority of FHF were detected in HBV 13 (38.2%) followed by 12 (35.3%) HEV. There were 8(23.5%) cases of NANEH. 3(0.88%) and 1(0.29%) of the NANEH cases were positive for SEN and TTV viruses respectively. Genotype D was the most prevalent HBV genotype 7(55.55%) followed by genotype F 2(15.38%) and genotype A (7.69%).Conclusion: FHF continues to be a major challenge for the clinician because of its high mortality rate and the requirement for a multidisciplinary approach.References
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11. Riordan S, Williams R. Treatment of hepatic encephalopathy. N Eng J Med. 1997; 337: 473–478.
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15. Tang Z, Chen X, Yu Y, Zang G. Prevalence and clinical significance of SEN virus infection in patients with non A-E hepatitis and volunteer blood donors in Shanghai. World J Gastroenterol. 2008; 14:4204–8.
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26. Tan D, IM S, Yao J, Ng M. Acute sporadic hepatitis E virus infection in Southern China. J Hepatology. 1995; 23: 239-45.
27. Irshad M, Chaudhuri P, Joshi Y. Superoxide dismutase and total anti-oxidant levels in various forms of liver diseases. Hepatol Res. 2002; 23: 178-184.
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29. Umemura T, Yeo A, Sottini A, et al. SEN virus infection and its relation to transfusion-associated hepatitis. Hepatology. 2001; 33:1303–1311
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33. Imamura T, Yokosuka O, Kurihara T, et al. Distribution of hepatitis B viral genotypes and mutations in the core promoter and precore regions in acute forms of liver disease in patients from Chiba, Japan. Gut. 2003; 52:1630-7.
34. Wai C, Fontana R, Polson J, et al. The US Acute Liver Failure Study Group. Clinical outcome and virologic characteristics of hepatitis B-related acute liver failure in the United States. J Viral Hepat. 2005; 12:192-8.
35. Sami Hiba, Rizvi Meher, Azam Mohd, et al. Emergence of Hepatitis B Virus Genotype F in Aligarh Region of North India. Advances in Virology. 2013: Article ID 846849, 8 pages.
36. Chattopadhyay S, Das B, Kar P. Hepatitis B virus genotypes in chronic liver disease patients from New Delhi, India. World J Gastroenterol. 2006; 12:6702-6706.
2. Schiodt F, Rochling F, Casey D, Lee W. Acetaminophen toxicity in an urban county hospital. N Engl J Med. 1997; 337: 1112–7.
3. Trey C, Davidson C. Inc: Popper H, Schaffner F, editors. The management of fulminant hepatic failure. Progress in Liver Disease. 1970; Volume 3. New York: Grune and Stratton: 282–98.
4. Vaquero J and Andres T. Etiology and management of fulminant hepatic failure. Current Gastroenterology Reports. 2003; 5:39–47.
5. Khuroo M. Acute liver failure in India. Hepatology. 1997; 26: 244–246.
6. Khuroo M, Teli M, Skidmore , Sofi M, Khuroo M. Incidence and severity of viral hepatitis in pregnancy. Am J Med. 1981; 70: 252–255.
7. Baumert T, Rogers S, Hasegawa K, Liang T. Two core promotor mutations identified in a hepatitis B virus strain associated with fulminant hepatitis result in enhanced viral replication. J Clin Invest. 1996; 98: 2268–76.
8. Rivero M, Crespo J, Fabrega E, et al. Apoptosis mediated by the Fas system in the fulminant hepatitis by hepatitis B virus. J Viral Hepat. 2002; 9:107–13.
9. Norder H, Courouce A, Magnius L. Complete genomes, phylogenetic relatedness, and structural proteins of six strains of the hepatitis B virus, four of which represent two new genotypes. Virology. 1994; 198:489–503.
10. Mahtab M, Rahman S, Khan M, Mamun A, Afroz S. Etiology of fulminant hepatic failure: Experience from a tertiary hospital in Bangladesh. Hepatobiliary Pancreat Dis Int. 2008; 7: 161–4.
11. Riordan S, Williams R. Treatment of hepatic encephalopathy. N Eng J Med. 1997; 337: 473–478.
12. Sherlock S, Dooley J. Diseases of the liver and biliary system, Oxford: Blackwell Scientific Publications; 1997: 9th edn.
13. O. Kirschberg, C. Schuttler, R. Repp, and S. Schaefer. A multiplex-PCR to identify hepatitis B virus—genotypes A–F. Journal of Clinical Virology. 2004; 29: 39–43.
14. Naito H, Hayashi S, Abe K. Rapid and specific genotyping system for hepatitis B virus corresponding to six major genotypes by PCR using type-specific primers. J Clin Microbiol. 2001; 39: 362-4.
15. Tang Z, Chen X, Yu Y, Zang G. Prevalence and clinical significance of SEN virus infection in patients with non A-E hepatitis and volunteer blood donors in Shanghai. World J Gastroenterol. 2008; 14:4204–8.
16. Biagini P, Gallian P, Attoui H, Cantaloube J, de Micco P, de Lamballerie. Determination and phylogenetic analysis of partial sequences from TT virus isolates. J Gen Virol. 1999; 80:419–24.
17. Fujiwara K., Yokosuka O, Ehata T, et al. Association between severity of type A hepatitis and nucleotide variations in the 5' non-translated region of hepatitis A virus RNA: strains from fulminant hepatitis have fewer nucleotide substitutions. Gut. 2002; 51: 82-8.
18. Khuroo M. Study of an epidemic of non-A, non-B hepatitis: possibility of another human hepatitis virus distinct from post-transfusion non-A, non-B type. Am J Med. 1980; 68: 818–823.
19. Khuroo M, Rustgi V, Dawson G et al. Spectrum of hepatitisE virus in India. J Med Virol. 1994; 43: 281–286.
20. Schiodt F, Atillasoy E, Shakil O, Schiff E, Caldwell C, Kowdley K, Stribling R, et al.1999. Etiology and outcome for 295 patients with acute liver failure in the United States. Liver Transpl Surg. 1999; 5: 29 –34.
21. O’Grady J, Alexander G, Hayllar K, Williams R. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology. 1989; 97: 439 –445.
22. Farci P, Alter H, Shimoda A et al. Hepatitis C virus-associated fulminant hepatic failure. N Engl J Med. 1997; 335: 631–634.
23. Takahashi Y, Shimizu M. Aetiology and prognosis of fulminant viral hepatitis in Japan: a multicentric study. J Gastroenterol Hepatol. 1991; 6: 159–164.
24. Nanda S, Yalchinkaya K, Panigrahi A, Acharya S, Jameel S, Panda S. Etiological role of hepatitis E virus in sporadic fulminant hepatitis. J Med Virol. 1994; 42: 133–137.
25. Nejdar S, Mitchell F, Biswas R. Simultaneous amplification and detection of specific hepatitis B virus and hepatitis C virus genomic sequences in serum samples. J Med Virol. 1994; 42: 212-6.
26. Tan D, IM S, Yao J, Ng M. Acute sporadic hepatitis E virus infection in Southern China. J Hepatology. 1995; 23: 239-45.
27. Irshad M, Chaudhuri P, Joshi Y. Superoxide dismutase and total anti-oxidant levels in various forms of liver diseases. Hepatol Res. 2002; 23: 178-184.
28. Rizvi Meher, Jahan Shafquat, Azam Mohd, Ajmal M.R, Shukla Indu, Malik Abida, et al. Prevalence and assessment of role of SEN virus in acute and chronic hepatitis in India. Tropical Gastroenterology. 2013; 34(4):227–234.
29. Umemura T, Yeo A, Sottini A, et al. SEN virus infection and its relation to transfusion-associated hepatitis. Hepatology. 2001; 33:1303–1311
30. Schroter M, Laufs R, Zollner B, Knodler B, Schafer P, Sterneck M, et al. Prevalence of SENV-H viraemia among healthy subjects and individuals at risk for parenterally transmitted diseases in Germany. J Viral Hepatology. 2002; 9: 455 – 459.
31. Sanchez-Tapias , Costa J, Mas A, Bruguera M, Rodes J. Influence of hepatitis B virus genotype on the long-term outcome of chronic hepatitis B in western patients. Gastroenterology. 2002; 123: 1848-1856.
32. Hou J, Lin Y, Waters J, et al. Detection and significance of a G1862T variant of hepatitis B virus in Chinese patients with fulminant hepatitis. J Gen Virol. 2002; 83:2291-8.
33. Imamura T, Yokosuka O, Kurihara T, et al. Distribution of hepatitis B viral genotypes and mutations in the core promoter and precore regions in acute forms of liver disease in patients from Chiba, Japan. Gut. 2003; 52:1630-7.
34. Wai C, Fontana R, Polson J, et al. The US Acute Liver Failure Study Group. Clinical outcome and virologic characteristics of hepatitis B-related acute liver failure in the United States. J Viral Hepat. 2005; 12:192-8.
35. Sami Hiba, Rizvi Meher, Azam Mohd, et al. Emergence of Hepatitis B Virus Genotype F in Aligarh Region of North India. Advances in Virology. 2013: Article ID 846849, 8 pages.
36. Chattopadhyay S, Das B, Kar P. Hepatitis B virus genotypes in chronic liver disease patients from New Delhi, India. World J Gastroenterol. 2006; 12:6702-6706.
Published
2016-02-25
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