Unusual symptoms

In less than 1% of cases, people infected with hepatitis A virus may develop an acute form of rapid liver failure called fulminant hepatitis, which can be severe or even fatal.1 Fulminant liver failure can lead to impaired blood clotting, metabolic disorders, brain dysfunction and coma. The risk of developing fulminant hepatitis is significantly higher amongst people with pre-existing liver disease, including chronic hepatitis B or C.2

Other atypical manifestations of hepatitis A virus infection include relapsing hepatitis, bile duct blockage, autoimmune hepatitis and a variety of other conditions unrelated to the liver. Relapsing hepatitis, characterised by prolonged or recurring symptoms and abnormal laboratory values occurs in an estimated 5 to 20% of cases.3,4 Manifestations due to effects outside the liver may include arthritis, skin rash, enlarged spleen, blood cell disorders, kidney dysfunction, and blood vessel inflammation.

References

  1. Rezende G et al. Viral and clinical factors associated with the fulminant course of hepatitis A infection. Hepatology 38: 613-618, 2003
  2. Vento S et al. Fulminant hepatitis associated with hepatitis A virus superinfection in patients with chronic hepatitis C. N Engl J Med 338: 286-290, 1998
  3. Schiff ER Atypical clinical manifestations of hepatitis A. Vaccine 10: S18-S20, 1992
  4. Glikson M et al. Relapsing hepatitis A: review of 14 cases and literature survey. Medicine (Baltimore) 71: 14-23, 1992
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