Abstract
We analyzed the factors related to the severity of acute viral hepatitis. Subjects were thirty-nine patients consisting of thirteen cases who underwent the severe form with the depression of hepaplastin test less than 30% during the acute phase and twentysix cases of fulminant hepatitis and subacute hepatitis in 408 cases with acute viral hepatitis (type A: n=66, sporadic type B: n=113, post-transfusion type B: n=17, sporadic non-A, non-B: n=91, post-transfusion non-A, non-B: n=121), Prevalence of the severe form in type A, sporadic type B, post-transfusion type B, sporadic non-A, non-B and post-transfusion non-A, non-B was 4.5% (n=3), 11.5% (n=13), 29.4% (n=5), 19.8% (n=18) and 0% (n=0), and mortality was 0%, 30.8%, 100%, 72.2% and 0%, respectively. Anti-HCV was not detected in sera of type A and type B, nor was anti-HDV in sera of type B, so mechanism for the severity was not likely to be the cumulative damage of the two viruses. In sera of the severe form of sporadic non-A, non-B hepatitis anti-HCV was not detected, so the infection of HCV was unknown. As a serological marker for severity in acute viral hepatitis type B, anti-HBV surface to be positive from early phase was especially meaningful, whereas anti-preS2 was not useful. The findings of liver biopsy or necropsy specimens in fatal cases revealed submassive or massive necrosis, so for survival it was thought that an intensive treatment for hepatic failure should be done as soon from the onset of hepatitis as possible.
