The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos
Identifieur interne : 007058 ( Main/Exploration ); précédent : 007057; suivant : 007059The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos
Auteurs : Bounkong Syhavong ; Bouachanh Rasachack ; Lee Smythe [Australie] ; Jean-Marc Rolain [France] ; Anne-Marie Roque-Afonso [France] ; Kemajittra Jenjaroen [Thaïlande] ; Vimone Soukkhaserm ; Simmaly Phongmany ; Rattanaphone Phetsouvanh [Royaume-Uni] ; Sune Soukkhaserm ; Te Thammavong ; Mayfong Mayxay [Royaume-Uni] ; Stuart D. Blacksell [Thaïlande, Royaume-Uni] ; Eleanor Barnes [Royaume-Uni] ; Philippe Parola [France] ; Elisabeth Dussaix [France] ; Didier Raoult [France] ; Isla Humphreys [Royaume-Uni] ; Paul Klenerman [Royaume-Uni] ; Nicholas J. White [Thaïlande, Royaume-Uni] ; Paul N. Newton [Royaume-Uni]Source :
- Transactions of The Royal Society of Tropical Medicine and Hygiene [ 0035-9203 ] ; 2010-07.
Descripteurs français
- Pascal (Inist)
- Wicri :
English descriptors
- KwdEn :
Abstract
There is little information on the diverse infectious causes of jaundice and hepatitis in the Asiatic tropics. Serology (hepatitis A, B, C and E, leptospirosis, dengue, rickettsia), antigen tests (dengue), PCR assays (hepatitis A, C and E) and blood cultures (septicaemia) were performed on samples from 392 patients admitted with jaundice or raised transaminases (≥ × 3) to Mahosot Hospital, Vientiane, Laos over 3 years. Conservative definitions suggested diagnoses of dengue (8.4%), rickettsioses (7.3%), leptospirosis (6.8%), hepatitis B (4.9%), hepatitis C (4.9%), community-acquired septicaemia (3.3%) and hepatitis E (1.6%). Although anti-hepatitis A virus (HAV) IgM antibody results suggested that 35.8% of patients had acute HAV infections, anti-HAV IgG antibody avidity and HAV PCR suggested that 82% had polyclonal activation and not acute HAV infections. Scrub typhus, murine typhus or leptospirosis were present in 12.8% of patients and were associated with meningism and relatively low AST and ALT elevation. These patients would be expected to respond to empirical doxycycline therapy which, in the absence of virological diagnosis and treatment, may be an appropriate cost-effective intervention in Lao patients with jaundice/hepatitis.
Url:
- https://api.istex.fr/document/DEC1F87054742B503CEF494BE7745DBFB1A60E95/fulltext/pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2896487
DOI: 10.1016/j.trstmh.2010.03.002
Affiliations:
- Australie, France, Royaume-Uni, Thaïlande
- Angleterre, Oxfordshire, Provence-Alpes-Côte d'Azur
- Marseille, Oxford
- Université d'Oxford, Université de la Méditerranée
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Hepatitis</term>
<term>Hepatitis E virus</term>
<term>Human</term>
<term>Jaundice</term>
<term>Laos</term>
<term>Leptospirosis</term>
<term>Rickettsia typhi</term>
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<keywords scheme="Pascal" xml:lang="fr"><term>Homme</term>
<term>Hépatite</term>
<term>Ictère</term>
<term>Laos</term>
<term>Leptospirose</term>
<term>Médecine tropicale</term>
<term>Rickettsia typhi</term>
<term>Virus hépatite E</term>
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<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Laos</term>
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<front><div type="abstract">There is little information on the diverse infectious causes of jaundice and hepatitis in the Asiatic tropics. Serology (hepatitis A, B, C and E, leptospirosis, dengue, rickettsia), antigen tests (dengue), PCR assays (hepatitis A, C and E) and blood cultures (septicaemia) were performed on samples from 392 patients admitted with jaundice or raised transaminases (≥ × 3) to Mahosot Hospital, Vientiane, Laos over 3 years. Conservative definitions suggested diagnoses of dengue (8.4%), rickettsioses (7.3%), leptospirosis (6.8%), hepatitis B (4.9%), hepatitis C (4.9%), community-acquired septicaemia (3.3%) and hepatitis E (1.6%). Although anti-hepatitis A virus (HAV) IgM antibody results suggested that 35.8% of patients had acute HAV infections, anti-HAV IgG antibody avidity and HAV PCR suggested that 82% had polyclonal activation and not acute HAV infections. Scrub typhus, murine typhus or leptospirosis were present in 12.8% of patients and were associated with meningism and relatively low AST and ALT elevation. These patients would be expected to respond to empirical doxycycline therapy which, in the absence of virological diagnosis and treatment, may be an appropriate cost-effective intervention in Lao patients with jaundice/hepatitis.</div>
</front>
</TEI>
<affiliations><list><country><li>Australie</li>
<li>France</li>
<li>Royaume-Uni</li>
<li>Thaïlande</li>
</country>
<region><li>Angleterre</li>
<li>Oxfordshire</li>
<li>Provence-Alpes-Côte d'Azur</li>
</region>
<settlement><li>Marseille</li>
<li>Oxford</li>
</settlement>
<orgName><li>Université d'Oxford</li>
<li>Université de la Méditerranée</li>
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<country name="Australie"><noRegion><name sortKey="Smythe, Lee" sort="Smythe, Lee" uniqKey="Smythe L" first="Lee" last="Smythe">Lee Smythe</name>
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<country name="France"><region name="Provence-Alpes-Côte d'Azur"><name sortKey="Rolain, Jean Marc" sort="Rolain, Jean Marc" uniqKey="Rolain J" first="Jean-Marc" last="Rolain">Jean-Marc Rolain</name>
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<name sortKey="Dussaix, Elisabeth" sort="Dussaix, Elisabeth" uniqKey="Dussaix E" first="Elisabeth" last="Dussaix">Elisabeth Dussaix</name>
<name sortKey="Parola, Philippe" sort="Parola, Philippe" uniqKey="Parola P" first="Philippe" last="Parola">Philippe Parola</name>
<name sortKey="Raoult, Didier" sort="Raoult, Didier" uniqKey="Raoult D" first="Didier" last="Raoult">Didier Raoult</name>
<name sortKey="Roque Afonso, Anne Marie" sort="Roque Afonso, Anne Marie" uniqKey="Roque Afonso A" first="Anne-Marie" last="Roque-Afonso">Anne-Marie Roque-Afonso</name>
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<country name="Thaïlande"><noRegion><name sortKey="Jenjaroen, Kemajittra" sort="Jenjaroen, Kemajittra" uniqKey="Jenjaroen K" first="Kemajittra" last="Jenjaroen">Kemajittra Jenjaroen</name>
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<name sortKey="Blacksell, Stuart D" sort="Blacksell, Stuart D" uniqKey="Blacksell S" first="Stuart D." last="Blacksell">Stuart D. Blacksell</name>
<name sortKey="White, Nicholas J" sort="White, Nicholas J" uniqKey="White N" first="Nicholas J." last="White">Nicholas J. White</name>
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<country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Phetsouvanh, Rattanaphone" sort="Phetsouvanh, Rattanaphone" uniqKey="Phetsouvanh R" first="Rattanaphone" last="Phetsouvanh">Rattanaphone Phetsouvanh</name>
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<name sortKey="Barnes, Eleanor" sort="Barnes, Eleanor" uniqKey="Barnes E" first="Eleanor" last="Barnes">Eleanor Barnes</name>
<name sortKey="Blacksell, Stuart D" sort="Blacksell, Stuart D" uniqKey="Blacksell S" first="Stuart D." last="Blacksell">Stuart D. Blacksell</name>
<name sortKey="Humphreys, Isla" sort="Humphreys, Isla" uniqKey="Humphreys I" first="Isla" last="Humphreys">Isla Humphreys</name>
<name sortKey="Klenerman, Paul" sort="Klenerman, Paul" uniqKey="Klenerman P" first="Paul" last="Klenerman">Paul Klenerman</name>
<name sortKey="Mayxay, Mayfong" sort="Mayxay, Mayfong" uniqKey="Mayxay M" first="Mayfong" last="Mayxay">Mayfong Mayxay</name>
<name sortKey="Newton, Paul N" sort="Newton, Paul N" uniqKey="Newton P" first="Paul N." last="Newton">Paul N. Newton</name>
<name sortKey="White, Nicholas J" sort="White, Nicholas J" uniqKey="White N" first="Nicholas J." last="White">Nicholas J. White</name>
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