The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos
Identifieur interne : 007591 ( Main/Merge ); précédent : 007590; suivant : 007592The 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
- Wicri :
- geographic : Laos.
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
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Phetsouvanh</name><affiliation></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Soukkhaserm, Sune" sort="Soukkhaserm, Sune" uniqKey="Soukkhaserm S" first="Sune" last="Soukkhaserm">Sune Soukkhaserm</name><affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Thammavong, Te" sort="Thammavong, Te" uniqKey="Thammavong T" first="Te" last="Thammavong">Te Thammavong</name><affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Mayxay, Mayfong" sort="Mayxay, Mayfong" uniqKey="Mayxay M" first="Mayfong" last="Mayxay">Mayfong Mayxay</name><affiliation></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation><affiliation></affiliation></author><author><name sortKey="Blacksell, Stuart D" sort="Blacksell, Stuart D" uniqKey="Blacksell S" first="Stuart D." last="Blacksell">Stuart D. Blacksell</name><affiliation></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea><wicri:noRegion>Bangkok 10400</wicri:noRegion></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Barnes, Eleanor" sort="Barnes, Eleanor" uniqKey="Barnes E" first="Eleanor" last="Barnes">Eleanor Barnes</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Parola, Philippe" sort="Parola, Philippe" uniqKey="Parola P" first="Philippe" last="Parola">Philippe Parola</name><affiliation wicri:level="4"><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement><settlement type="city">Marseille</settlement></placeName><orgName type="university">Université de la Méditerranée</orgName></affiliation></author><author><name sortKey="Dussaix, Elisabeth" sort="Dussaix, Elisabeth" uniqKey="Dussaix E" first="Elisabeth" last="Dussaix">Elisabeth Dussaix</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif</wicri:regionArea><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author><author><name sortKey="Raoult, Didier" sort="Raoult, Didier" uniqKey="Raoult D" first="Didier" last="Raoult">Didier Raoult</name><affiliation wicri:level="4"><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement><settlement type="city">Marseille</settlement></placeName><orgName type="university">Université de la Méditerranée</orgName></affiliation></author><author><name sortKey="Humphreys, Isla" sort="Humphreys, Isla" uniqKey="Humphreys I" first="Isla" last="Humphreys">Isla Humphreys</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Klenerman, Paul" sort="Klenerman, Paul" uniqKey="Klenerman P" first="Paul" last="Klenerman">Paul Klenerman</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="White, Nicholas J" sort="White, Nicholas J" uniqKey="White N" first="Nicholas J." last="White">Nicholas J. White</name><affiliation></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea><wicri:noRegion>Bangkok 10400</wicri:noRegion></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Newton, Paul N" sort="Newton, Paul N" uniqKey="Newton P" first="Paul N." last="Newton">Paul N. Newton</name><affiliation></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation><affiliation></affiliation><affiliation></affiliation><affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Transactions of The Royal Society of Tropical Medicine and Hygiene</title><title level="j" type="abbrev">Trans R Soc Trop Med Hyg</title><idno type="ISSN">0035-9203</idno><idno type="eISSN">1878-3503</idno><imprint><publisher>Royal Society of Tropical Medicine and Hygiene</publisher><date type="published" when="2010-07">2010-07</date><biblScope unit="volume">104</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="475">475</biblScope><biblScope unit="page" to="483">483</biblScope></imprint><idno type="ISSN">0035-9203</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0035-9203</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Hepatitis E virus</term><term>Jaundice</term><term>Laos</term><term>Leptospirosis</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Laos</term></keywords></textClass></profileDesc></teiHeader><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><double doi="10.1016/j.trstmh.2010.03.002"><ISTEX><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos</title><author><name sortKey="Syhavong, Bounkong" sort="Syhavong, Bounkong" uniqKey="Syhavong B" first="Bounkong" last="Syhavong">Bounkong Syhavong</name></author><author><name sortKey="Rasachack, Bouachanh" sort="Rasachack, Bouachanh" uniqKey="Rasachack B" first="Bouachanh" last="Rasachack">Bouachanh Rasachack</name></author><author><name sortKey="Smythe, Lee" sort="Smythe, Lee" uniqKey="Smythe L" first="Lee" last="Smythe">Lee Smythe</name></author><author><name sortKey="Rolain, Jean Marc" sort="Rolain, Jean Marc" uniqKey="Rolain J" first="Jean-Marc" last="Rolain">Jean-Marc Rolain</name></author><author><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></author><author><name sortKey="Jenjaroen, Kemajittra" sort="Jenjaroen, Kemajittra" uniqKey="Jenjaroen K" first="Kemajittra" last="Jenjaroen">Kemajittra Jenjaroen</name></author><author><name sortKey="Soukkhaserm, Vimone" sort="Soukkhaserm, Vimone" uniqKey="Soukkhaserm V" first="Vimone" last="Soukkhaserm">Vimone Soukkhaserm</name></author><author><name sortKey="Phongmany, Simmaly" sort="Phongmany, Simmaly" uniqKey="Phongmany S" first="Simmaly" last="Phongmany">Simmaly Phongmany</name></author><author><name sortKey="Phetsouvanh, Rattanaphone" sort="Phetsouvanh, Rattanaphone" uniqKey="Phetsouvanh R" first="Rattanaphone" last="Phetsouvanh">Rattanaphone Phetsouvanh</name></author><author><name sortKey="Soukkhaserm, Sune" sort="Soukkhaserm, Sune" uniqKey="Soukkhaserm S" first="Sune" last="Soukkhaserm">Sune Soukkhaserm</name></author><author><name sortKey="Thammavong, Te" sort="Thammavong, Te" uniqKey="Thammavong T" first="Te" last="Thammavong">Te Thammavong</name></author><author><name sortKey="Mayxay, Mayfong" sort="Mayxay, Mayfong" uniqKey="Mayxay M" first="Mayfong" last="Mayxay">Mayfong Mayxay</name></author><author><name sortKey="Blacksell, Stuart D" sort="Blacksell, Stuart D" uniqKey="Blacksell S" first="Stuart D." last="Blacksell">Stuart D. Blacksell</name></author><author><name sortKey="Barnes, Eleanor" sort="Barnes, Eleanor" uniqKey="Barnes E" first="Eleanor" last="Barnes">Eleanor Barnes</name></author><author><name sortKey="Parola, Philippe" sort="Parola, Philippe" uniqKey="Parola P" first="Philippe" last="Parola">Philippe Parola</name></author><author><name sortKey="Dussaix, Elisabeth" sort="Dussaix, Elisabeth" uniqKey="Dussaix E" first="Elisabeth" last="Dussaix">Elisabeth Dussaix</name></author><author><name sortKey="Raoult, Didier" sort="Raoult, Didier" uniqKey="Raoult D" first="Didier" last="Raoult">Didier Raoult</name></author><author><name sortKey="Humphreys, Isla" sort="Humphreys, Isla" uniqKey="Humphreys I" first="Isla" last="Humphreys">Isla Humphreys</name></author><author><name sortKey="Klenerman, Paul" sort="Klenerman, Paul" uniqKey="Klenerman P" first="Paul" last="Klenerman">Paul Klenerman</name></author><author><name sortKey="White, Nicholas J" sort="White, Nicholas J" uniqKey="White N" first="Nicholas J." last="White">Nicholas J. White</name></author><author><name sortKey="Newton, Paul N" sort="Newton, Paul N" uniqKey="Newton P" first="Paul N." last="Newton">Paul N. Newton</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:DEC1F87054742B503CEF494BE7745DBFB1A60E95</idno><date when="2010" year="2010">2010</date><idno type="doi">10.1016/j.trstmh.2010.03.002</idno><idno type="url">https://api.istex.fr/document/DEC1F87054742B503CEF494BE7745DBFB1A60E95/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">002968</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">002968</idno><idno type="wicri:Area/Istex/Curation">002968</idno><idno type="wicri:Area/Istex/Checkpoint">000956</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">000956</idno><idno type="wicri:doubleKey">0035-9203:2010:Syhavong B:the:infective:causes</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos</title><author><name sortKey="Syhavong, Bounkong" sort="Syhavong, Bounkong" uniqKey="Syhavong B" first="Bounkong" last="Syhavong">Bounkong Syhavong</name><affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Rasachack, Bouachanh" sort="Rasachack, Bouachanh" uniqKey="Rasachack B" first="Bouachanh" last="Rasachack">Bouachanh Rasachack</name><affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Smythe, Lee" sort="Smythe, Lee" uniqKey="Smythe L" first="Lee" last="Smythe">Lee Smythe</name><affiliation wicri:level="1"><country xml:lang="fr">Australie</country><wicri:regionArea>WHO/AO/OIE Collaborating Centre for Reference & Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Coopers Plains, Queensland, 4108</wicri:regionArea><wicri:noRegion>4108</wicri:noRegion></affiliation></author><author><name sortKey="Rolain, Jean Marc" sort="Rolain, Jean Marc" uniqKey="Rolain J" first="Jean-Marc" last="Rolain">Jean-Marc Rolain</name><affiliation wicri:level="4"><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement><settlement type="city">Marseille</settlement></placeName><orgName type="university">Université de la Méditerranée</orgName></affiliation></author><author><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><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif</wicri:regionArea><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author><author><name sortKey="Jenjaroen, Kemajittra" sort="Jenjaroen, Kemajittra" uniqKey="Jenjaroen K" first="Kemajittra" last="Jenjaroen">Kemajittra Jenjaroen</name><affiliation wicri:level="1"><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea><wicri:noRegion>Bangkok 10400</wicri:noRegion></affiliation></author><author><name sortKey="Soukkhaserm, Vimone" sort="Soukkhaserm, Vimone" uniqKey="Soukkhaserm V" first="Vimone" last="Soukkhaserm">Vimone Soukkhaserm</name><affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Phongmany, Simmaly" sort="Phongmany, Simmaly" uniqKey="Phongmany S" first="Simmaly" last="Phongmany">Simmaly Phongmany</name><affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Phetsouvanh, Rattanaphone" sort="Phetsouvanh, Rattanaphone" uniqKey="Phetsouvanh R" first="Rattanaphone" last="Phetsouvanh">Rattanaphone Phetsouvanh</name><affiliation></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Soukkhaserm, Sune" sort="Soukkhaserm, Sune" uniqKey="Soukkhaserm S" first="Sune" last="Soukkhaserm">Sune Soukkhaserm</name><affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Thammavong, Te" sort="Thammavong, Te" uniqKey="Thammavong T" first="Te" last="Thammavong">Te Thammavong</name><affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Mayxay, Mayfong" sort="Mayxay, Mayfong" uniqKey="Mayxay M" first="Mayfong" last="Mayxay">Mayfong Mayxay</name><affiliation></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation><affiliation></affiliation></author><author><name sortKey="Blacksell, Stuart D" sort="Blacksell, Stuart D" uniqKey="Blacksell S" first="Stuart D." last="Blacksell">Stuart D. Blacksell</name><affiliation></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea><wicri:noRegion>Bangkok 10400</wicri:noRegion></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Barnes, Eleanor" sort="Barnes, Eleanor" uniqKey="Barnes E" first="Eleanor" last="Barnes">Eleanor Barnes</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Parola, Philippe" sort="Parola, Philippe" uniqKey="Parola P" first="Philippe" last="Parola">Philippe Parola</name><affiliation wicri:level="4"><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement><settlement type="city">Marseille</settlement></placeName><orgName type="university">Université de la Méditerranée</orgName></affiliation></author><author><name sortKey="Dussaix, Elisabeth" sort="Dussaix, Elisabeth" uniqKey="Dussaix E" first="Elisabeth" last="Dussaix">Elisabeth Dussaix</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif</wicri:regionArea><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author><author><name sortKey="Raoult, Didier" sort="Raoult, Didier" uniqKey="Raoult D" first="Didier" last="Raoult">Didier Raoult</name><affiliation wicri:level="4"><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement><settlement type="city">Marseille</settlement></placeName><orgName type="university">Université de la Méditerranée</orgName></affiliation></author><author><name sortKey="Humphreys, Isla" sort="Humphreys, Isla" uniqKey="Humphreys I" first="Isla" last="Humphreys">Isla Humphreys</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Klenerman, Paul" sort="Klenerman, Paul" uniqKey="Klenerman P" first="Paul" last="Klenerman">Paul Klenerman</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="White, Nicholas J" sort="White, Nicholas J" uniqKey="White N" first="Nicholas J." last="White">Nicholas J. White</name><affiliation></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea><wicri:noRegion>Bangkok 10400</wicri:noRegion></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Newton, Paul N" sort="Newton, Paul N" uniqKey="Newton P" first="Paul N." last="Newton">Paul N. Newton</name><affiliation></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation><affiliation></affiliation><affiliation></affiliation><affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Transactions of The Royal Society of Tropical Medicine and Hygiene</title><title level="j" type="abbrev">Trans R Soc Trop Med Hyg</title><idno type="ISSN">0035-9203</idno><idno type="eISSN">1878-3503</idno><imprint><publisher>Royal Society of Tropical Medicine and Hygiene</publisher><date type="published" when="2010-07">2010-07</date><biblScope unit="volume">104</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="475">475</biblScope><biblScope unit="page" to="483">483</biblScope></imprint><idno type="ISSN">0035-9203</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0035-9203</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Hepatitis E virus</term><term>Jaundice</term><term>Laos</term><term>Leptospirosis</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Laos</term></keywords></textClass></profileDesc></teiHeader><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></ISTEX><PMC><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos</title><author><name sortKey="Syhavong, Bounkong" sort="Syhavong, Bounkong" uniqKey="Syhavong B" first="Bounkong" last="Syhavong">Bounkong Syhavong</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation></author><author><name sortKey="Rasachack, Bouachanh" sort="Rasachack, Bouachanh" uniqKey="Rasachack B" first="Bouachanh" last="Rasachack">Bouachanh Rasachack</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation></author><author><name sortKey="Smythe, Lee" sort="Smythe, Lee" uniqKey="Smythe L" first="Lee" last="Smythe">Lee Smythe</name><affiliation wicri:level="1"><nlm:aff id="aff2">WHO/AO/OIE Collaborating Centre for Reference & Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Coopers Plains, Queensland, 4108, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>WHO/AO/OIE Collaborating Centre for Reference & Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Coopers Plains, Queensland, 4108</wicri:regionArea><wicri:noRegion>4108</wicri:noRegion></affiliation></author><author><name sortKey="Rolain, Jean Marc" sort="Rolain, Jean Marc" uniqKey="Rolain J" first="Jean-Marc" last="Rolain">Jean-Marc Rolain</name><affiliation wicri:level="4"><nlm:aff id="aff3">URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement><settlement type="city">Marseille</settlement></placeName><orgName type="university">Université de la Méditerranée</orgName></affiliation></author><author><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><affiliation wicri:level="1"><nlm:aff id="aff4">AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif, 94804 France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif</wicri:regionArea><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author><author><name sortKey="Jenjaroen, Kemajittra" sort="Jenjaroen, Kemajittra" uniqKey="Jenjaroen K" first="Kemajittra" last="Jenjaroen">Kemajittra Jenjaroen</name><affiliation wicri:level="1"><nlm:aff id="aff5">Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand</nlm:aff><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea><wicri:noRegion>Bangkok 10400</wicri:noRegion></affiliation></author><author><name sortKey="Soukkhaserm, Vimone" sort="Soukkhaserm, Vimone" uniqKey="Soukkhaserm V" first="Vimone" last="Soukkhaserm">Vimone Soukkhaserm</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation></author><author><name sortKey="Phongmany, Simmaly" sort="Phongmany, Simmaly" uniqKey="Phongmany S" first="Simmaly" last="Phongmany">Simmaly Phongmany</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation></author><author><name sortKey="Phetsouvanh, Rattanaphone" sort="Phetsouvanh, Rattanaphone" uniqKey="Phetsouvanh R" first="Rattanaphone" last="Phetsouvanh">Rattanaphone Phetsouvanh</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation><affiliation wicri:level="4"><nlm:aff id="aff6">Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Soukkhaserm, Sune" sort="Soukkhaserm, Sune" uniqKey="Soukkhaserm S" first="Sune" last="Soukkhaserm">Sune Soukkhaserm</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation></author><author><name sortKey="Thammavong, Te" sort="Thammavong, Te" uniqKey="Thammavong T" first="Te" last="Thammavong">Te Thammavong</name><affiliation><nlm:aff id="aff7">National Blood Transfusion Centre, Lao Red Cross, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation></author><author><name sortKey="Mayxay, Mayfong" sort="Mayxay, Mayfong" uniqKey="Mayxay M" first="Mayfong" last="Mayxay">Mayfong Mayxay</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation><affiliation wicri:level="4"><nlm:aff id="aff6">Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation><affiliation><nlm:aff id="aff8">Faculty of Post Graduate Studies, University of Health Sciences, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation></author><author><name sortKey="Blacksell, Stuart D" sort="Blacksell, Stuart D" uniqKey="Blacksell S" first="Stuart D." last="Blacksell">Stuart D. Blacksell</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="aff5">Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand</nlm:aff><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea><wicri:noRegion>Bangkok 10400</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff6">Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Barnes, Eleanor" sort="Barnes, Eleanor" uniqKey="Barnes E" first="Eleanor" last="Barnes">Eleanor Barnes</name><affiliation wicri:level="4"><nlm:aff id="aff9">The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Parola, Philippe" sort="Parola, Philippe" uniqKey="Parola P" first="Philippe" last="Parola">Philippe Parola</name><affiliation wicri:level="4"><nlm:aff id="aff3">URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement><settlement type="city">Marseille</settlement></placeName><orgName type="university">Université de la Méditerranée</orgName></affiliation></author><author><name sortKey="Dussaix, Elisabeth" sort="Dussaix, Elisabeth" uniqKey="Dussaix E" first="Elisabeth" last="Dussaix">Elisabeth Dussaix</name><affiliation wicri:level="1"><nlm:aff id="aff4">AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif, 94804 France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif</wicri:regionArea><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author><author><name sortKey="Raoult, Didier" sort="Raoult, Didier" uniqKey="Raoult D" first="Didier" last="Raoult">Didier Raoult</name><affiliation wicri:level="4"><nlm:aff id="aff3">URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement><settlement type="city">Marseille</settlement></placeName><orgName type="university">Université de la Méditerranée</orgName></affiliation></author><author><name sortKey="Humphreys, Isla" sort="Humphreys, Isla" uniqKey="Humphreys I" first="Isla" last="Humphreys">Isla Humphreys</name><affiliation wicri:level="4"><nlm:aff id="aff9">The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Klenerman, Paul" sort="Klenerman, Paul" uniqKey="Klenerman P" first="Paul" last="Klenerman">Paul Klenerman</name><affiliation wicri:level="4"><nlm:aff id="aff9">The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="White, Nicholas J" sort="White, Nicholas J" uniqKey="White N" first="Nicholas J." last="White">Nicholas J. White</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="aff5">Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand</nlm:aff><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea><wicri:noRegion>Bangkok 10400</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff6">Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Newton, Paul N" sort="Newton, Paul N" uniqKey="Newton P" first="Paul N." last="Newton">Paul N. Newton</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation><affiliation wicri:level="4"><nlm:aff id="aff6">Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">20378138</idno><idno type="pmc">2896487</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2896487</idno><idno type="RBID">PMC:2896487</idno><idno type="doi">10.1016/j.trstmh.2010.03.002</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">002D37</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002D37</idno><idno type="wicri:Area/Pmc/Curation">002B87</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002B87</idno><idno type="wicri:Area/Pmc/Checkpoint">002451</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002451</idno><idno type="wicri:Area/Ncbi/Merge">000762</idno><idno type="wicri:Area/Ncbi/Curation">000762</idno><idno type="wicri:Area/Ncbi/Checkpoint">000762</idno><idno type="wicri:doubleKey">0035-9203:2010:Syhavong B:the:infective:causes</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos</title><author><name sortKey="Syhavong, Bounkong" sort="Syhavong, Bounkong" uniqKey="Syhavong B" first="Bounkong" last="Syhavong">Bounkong Syhavong</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation></author><author><name sortKey="Rasachack, Bouachanh" sort="Rasachack, Bouachanh" uniqKey="Rasachack B" first="Bouachanh" last="Rasachack">Bouachanh Rasachack</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation></author><author><name sortKey="Smythe, Lee" sort="Smythe, Lee" uniqKey="Smythe L" first="Lee" last="Smythe">Lee Smythe</name><affiliation wicri:level="1"><nlm:aff id="aff2">WHO/AO/OIE Collaborating Centre for Reference & Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Coopers Plains, Queensland, 4108, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>WHO/AO/OIE Collaborating Centre for Reference & Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Coopers Plains, Queensland, 4108</wicri:regionArea><wicri:noRegion>4108</wicri:noRegion></affiliation></author><author><name sortKey="Rolain, Jean Marc" sort="Rolain, Jean Marc" uniqKey="Rolain J" first="Jean-Marc" last="Rolain">Jean-Marc Rolain</name><affiliation wicri:level="4"><nlm:aff id="aff3">URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement><settlement type="city">Marseille</settlement></placeName><orgName type="university">Université de la Méditerranée</orgName></affiliation></author><author><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><affiliation wicri:level="1"><nlm:aff id="aff4">AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif, 94804 France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif</wicri:regionArea><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author><author><name sortKey="Jenjaroen, Kemajittra" sort="Jenjaroen, Kemajittra" uniqKey="Jenjaroen K" first="Kemajittra" last="Jenjaroen">Kemajittra Jenjaroen</name><affiliation wicri:level="1"><nlm:aff id="aff5">Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand</nlm:aff><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea><wicri:noRegion>Bangkok 10400</wicri:noRegion></affiliation></author><author><name sortKey="Soukkhaserm, Vimone" sort="Soukkhaserm, Vimone" uniqKey="Soukkhaserm V" first="Vimone" last="Soukkhaserm">Vimone Soukkhaserm</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation></author><author><name sortKey="Phongmany, Simmaly" sort="Phongmany, Simmaly" uniqKey="Phongmany S" first="Simmaly" last="Phongmany">Simmaly Phongmany</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation></author><author><name sortKey="Phetsouvanh, Rattanaphone" sort="Phetsouvanh, Rattanaphone" uniqKey="Phetsouvanh R" first="Rattanaphone" last="Phetsouvanh">Rattanaphone Phetsouvanh</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation><affiliation wicri:level="4"><nlm:aff id="aff6">Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Soukkhaserm, Sune" sort="Soukkhaserm, Sune" uniqKey="Soukkhaserm S" first="Sune" last="Soukkhaserm">Sune Soukkhaserm</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation></author><author><name sortKey="Thammavong, Te" sort="Thammavong, Te" uniqKey="Thammavong T" first="Te" last="Thammavong">Te Thammavong</name><affiliation><nlm:aff id="aff7">National Blood Transfusion Centre, Lao Red Cross, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation></author><author><name sortKey="Mayxay, Mayfong" sort="Mayxay, Mayfong" uniqKey="Mayxay M" first="Mayfong" last="Mayxay">Mayfong Mayxay</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation><affiliation wicri:level="4"><nlm:aff id="aff6">Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation><affiliation><nlm:aff id="aff8">Faculty of Post Graduate Studies, University of Health Sciences, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation></author><author><name sortKey="Blacksell, Stuart D" sort="Blacksell, Stuart D" uniqKey="Blacksell S" first="Stuart D." last="Blacksell">Stuart D. Blacksell</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="aff5">Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand</nlm:aff><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea><wicri:noRegion>Bangkok 10400</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff6">Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Barnes, Eleanor" sort="Barnes, Eleanor" uniqKey="Barnes E" first="Eleanor" last="Barnes">Eleanor Barnes</name><affiliation wicri:level="4"><nlm:aff id="aff9">The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Parola, Philippe" sort="Parola, Philippe" uniqKey="Parola P" first="Philippe" last="Parola">Philippe Parola</name><affiliation wicri:level="4"><nlm:aff id="aff3">URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement><settlement type="city">Marseille</settlement></placeName><orgName type="university">Université de la Méditerranée</orgName></affiliation></author><author><name sortKey="Dussaix, Elisabeth" sort="Dussaix, Elisabeth" uniqKey="Dussaix E" first="Elisabeth" last="Dussaix">Elisabeth Dussaix</name><affiliation wicri:level="1"><nlm:aff id="aff4">AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif, 94804 France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif</wicri:regionArea><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author><author><name sortKey="Raoult, Didier" sort="Raoult, Didier" uniqKey="Raoult D" first="Didier" last="Raoult">Didier Raoult</name><affiliation wicri:level="4"><nlm:aff id="aff3">URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement><settlement type="city">Marseille</settlement></placeName><orgName type="university">Université de la Méditerranée</orgName></affiliation></author><author><name sortKey="Humphreys, Isla" sort="Humphreys, Isla" uniqKey="Humphreys I" first="Isla" last="Humphreys">Isla Humphreys</name><affiliation wicri:level="4"><nlm:aff id="aff9">The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Klenerman, Paul" sort="Klenerman, Paul" uniqKey="Klenerman P" first="Paul" last="Klenerman">Paul Klenerman</name><affiliation wicri:level="4"><nlm:aff id="aff9">The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="White, Nicholas J" sort="White, Nicholas J" uniqKey="White N" first="Nicholas J." last="White">Nicholas J. White</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="aff5">Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand</nlm:aff><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea><wicri:noRegion>Bangkok 10400</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff6">Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Newton, Paul N" sort="Newton, Paul N" uniqKey="Newton P" first="Paul N." last="Newton">Paul N. Newton</name><affiliation><nlm:aff id="aff1">Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</nlm:aff><wicri:noCountry code="subfield">Lao PDR</wicri:noCountry></affiliation><affiliation wicri:level="4"><nlm:aff id="aff6">Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author></analytic><series><title level="j">Transactions of the Royal Society of Tropical Medicine and Hygiene</title><idno type="ISSN">0035-9203</idno><idno type="eISSN">1878-3503</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><p>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.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Bounlu, K" uniqKey="Bounlu K">K. Bounlu</name></author><author><name sortKey="Insisiengmay, S" uniqKey="Insisiengmay S">S. Insisiengmay</name></author><author><name sortKey="Vanthanouvong, K" uniqKey="Vanthanouvong K">K. Vanthanouvong</name></author><author><name sortKey="Saykham" uniqKey="Saykham">Saykham</name></author><author><name sortKey="Widjaja, S" uniqKey="Widjaja S">S. Widjaja</name></author><author><name sortKey="Iinuma, K" uniqKey="Iinuma K">K. Iinuma</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Laras, K" uniqKey="Laras K">K. Laras</name></author><author><name sortKey="Cao, B V" uniqKey="Cao B">B.V. 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