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Spengler U, Fischer HP, Caselmann WH. Liver Disease Associated with Viral Infections. ZAKIM AND BOYER'S HEPATOLOGY 2012. [PMCID: PMC7152320 DOI: 10.1016/b978-1-4377-0881-3.00034-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Zhang X, Chen HY, Zhu LY, Zeng LL, Wang F, Li QG, Shao FJ, Jiang HQ, Liu SJ, Ma YJ, Zhu Y, Ma YJ. Comparison of Hantaan and Seoul viral infections among patients with hemorrhagic fever with renal syndrome (HFRS) in Heilongjiang, China. ACTA ACUST UNITED AC 2011; 43:632-41. [PMID: 21428852 DOI: 10.3109/00365548.2011.566279] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Hemorrhagic fever with renal syndrome (HFRS) is a serious public health problem in China, and is primarily caused by either the Hantaan virus (HTNV) or Seoul virus (SEOV) strains. However, the causative hantavirus has only been definitively identified in a few HFRS cases, and detailed comparisons of patient data for the 2 strains are limited. METHODS We conducted a 1-y prospective study in Heilongjiang Province, China. A total of 152 patients from 3 hospitals met the HFRS diagnostic criteria used in China. The diagnosis was further confirmed by specific immunoglobulin M to HTNV or SEOV. In addition, serum samples were tested for the presence of HTNV or SEOV using a reverse transcription-polymerase chain reaction (RT-PCR). Clinical manifestations and laboratory findings in patients with the 2 hantaviruses were subsequently compared. RESULTS Eighty (61.1%) HTNV and 51 (38.9%) SEOV infections were identified. Fever and proteinuria, key to the diagnosis of HFRS, were observed in all patients. The clinical manifestations of hemorrhage and renal injury from SEOV infection were milder than those of HTNV infection. Interestingly, compared to patients with HTNV infection, patients with SEOV presented with a significantly longer febrile period, more normal white blood cell counts or even transient leukocytopenia, a higher incidence of liver injury related to disease severity, and a lower occurrence of the 5 typical phases of HFRS. The mortality was 6.3% in HTNV infections and 0% in SEOV infections. CONCLUSIONS Clinical manifestations of SEOV infection appear to be milder and less typical than HTNV. This information may help us to improve the diagnosis of SEOV-infected patients.
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Affiliation(s)
- Xin Zhang
- Department of Infectious Disease, the First Affiliated Hospital of Harbin Medical University, Harbin, China
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Affiliation(s)
- Henryk Dancygier
- Chair, Department of Medicine II, Klinikum Offenbach, Goethe University Frankfurt/Main, Starkenburgring 66, Offenbach, 63069 Germany
- Department of Medicine, Division of Liver Diseases, Mount Sinai School of Medicine, New York, NY USA
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Hepatobiliary and splenic infection. Infect Dis (Lond) 2010. [DOI: 10.1016/b978-0-323-04579-7.00039-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Gegúndez MI, Lledó L. [Infection due to Hantavirus and other rodent-borne viruses]. Enferm Infecc Microbiol Clin 2005; 23:492-500. [PMID: 16185565 DOI: 10.1157/13078828] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The term "robovirus" (rodent-borne virus) refers to viruses belonging to the Bunyaviridae (genus Hantavirus) and Arenaviridae families, which are occasionally transmitted to human beings from rodents, their natural hosts. Hantaviruses cause two human diseases: hemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome. Arenaviruses produce hemorrhagic fevers or acute central nervous system disease in humans. This article reviews the biology, epidemiology, pathogenesis, clinical features, diagnostic methods, treatment and prevention of hantavirus and, more concisely, arenavirus infections.
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Affiliation(s)
- María Isabel Gegúndez
- Departamento de Microbiología y Parasitología, Universidad de Alcalá, Madrid, Spain.
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Paraná R, Codes L, Andrade Z, Freitas LARD, Santos-Jesus R, Reis M, Cotrim H, Cunha S, Trepo C. Clinical, histologic and serologic evaluation of patients with acute non-A-E hepatitis in north-eastern Brazil: is it an infectious disease? Int J Infect Dis 2004; 7:222-30. [PMID: 14563227 DOI: 10.1016/s1201-9712(03)90056-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Non-A-E hepatitis and acute cryptogenic hepatitis are the names given to the disease of patients with clinical hepatitis, but in whom serologic evidence of A-E hepatitis has not been found. Over a period of 8 years, we evaluated in Brazil 32 patients who fulfilled the criteria for this diagnosis in order to determine patterns of the clinical illness, laboratory parameters, or histologic features. Each patient was subjected to virologic tests to exclude A-E hepatitis and cytomegalovirus/Epstein-Barr virus infection. Drug-induced hepatitis and autoimmune disease were also excluded. Wilson's disease was excluded in young patients. The course of the disease was clinical/biochemical recovery in 3 months in 25 patients and persistent alanine aminotransferase (ALT) elevation in 7 patients. Three of these had chronic hepatitis, and one had severe fibrosis on liver biopsy. During the acute illness, mean peak ALT was 1267 IU/L, bilirubin was 4.0 mg/dL, and ferritin was 1393 IU/mL. GB virus type C (GBV-C) was found in six patients, and TT virus (TTV) in five patients. We conclude that, in Brazil, non-A-E hepatitis probably originates from still unidentified viruses. The course of the disease and the histologic patterns are similar to those recorded for known viruses. Continuous survey for the specific etiologic agents is needed.
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Affiliation(s)
- Raymundo Paraná
- Gastro-Hepatology Unit, University Hospital of Bahia, Bahia, Brazil,CPgMS-UFBA, Bahia-Salvador, Brazil.
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Hujakka H, Koistinen V, Kuronen I, Eerikäinen P, Parviainen M, Lundkvist A, Vaheri A, Vapalahti O, Närvänen A. Diagnostic rapid tests for acute hantavirus infections: specific tests for Hantaan, Dobrava and Puumala viruses versus a hantavirus combination test. J Virol Methods 2003; 108:117-22. [PMID: 12565162 DOI: 10.1016/s0166-0934(02)00282-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Hantaviruses infecting humans in Eurasia include Hantaan, Seoul, Puumala and the closely related Dobrava and Saaremaa viruses. These viruses are causative agents of hemorrhagic fever with renal syndrome (HFRS), which is recognized as a severe health care problem in several countries. Diagnostics of hantavirus infections relies on serology, performed principally with enzyme immunoassay (EIA) or immunofluorescence assay (IFA). We developed four 5-min immunochromatographic IgM-antibody tests for diagnostics of acute Puumala, Dobrava and Hantaan virus infections and a similar combination test to detect all Eurasian pathogenic hantavirus infections. We evaluated the assays using 100 fingertip blood samples collected randomly from Finnish volunteers, 28 confirmed hantavirus IgM-negative sera, and 77 sera from patients with acute infections of various hantaviruses. The specificities and sensitivities of the Puumala-, Dobrava- and Hantaan virus -specific tests varied from 96 to 100%, whereas, the combination test showed 96% specificity and 80 to 93% sensitivity. Cross-reactions were observed commonly between the Dobrava and the Hantaan virus tests, but only rarely between the Puumala and the Hantaan virus, or the Puumala and the Dobrava virus, tests. Altogether, the rapid tests showed less cross-reactivity than the respective EIA tests. According to the results, the performance of these tests meets well the requirements for diagnostic use. Nevertheless, the specific one-antigen tests were markedly more sensitive than the combination test. However, if optimized, a combination test would be suitable for regions where several hantaviruses circulate.
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Affiliation(s)
- Helena Hujakka
- Department of Chemistry, University of Kuopio, PO Box 1627, FIN-70211, Kuopio, Finland.
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Markotić A, Nichol ST, Kuzman I, Sanchez AJ, Ksiazek TG, Gagro A, Rabatić S, Zgorelec R, Avsic-Zupanc T, Beus I, Dekaris D. Characteristics of Puumala and Dobrava infections in Croatia. J Med Virol 2002; 66:542-51. [PMID: 11857535 DOI: 10.1002/jmv.2179] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In this study, two different hantaviruses, Puumala virus (PUUV) and Dobrava virus (DOBV), were demonstrated for the first time to coexist and cause hemorrhagic fever with renal syndrome (HFRS) in Croatia. Phylogenetic analysis showed some differences among the nucleotide sequences of PUUV originating from Dinara mountain, which was more closely related to Austrian PUUV than other Croatian PUUV from Mala Kapela mountain. More consistency was found among the Croatian DOBV. HFRS was verified in 85 of 201 suspected cases recorded in 1995 during the largest HFRS outbreak in Croatia. Most of these cases were soldiers. With the exception of the coastal region and islands, all of Croatia was found to be an area endemic for HFRS. A statistically significantly higher proportion of DOBV-infected patients had acute renal failure, visual disturbance, severe thrombocytopenia, and elevated levels of nonsegmented leukocytes, creatine, and total bilirubin. The prevalence of gastrointestinal and electrocardiography disorders also was greater in DOBV-infected patients. Interestingly, significantly more PUUV-infected patients had elevated systolic blood pressure on admission to the hospital. Further prospective studies are necessary to shed more light on differences in HFRS severity associated with PUU and DOB viruses.
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Affiliation(s)
- A Markotić
- Institute of Immunology, Zagreb, Croatia.
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Kariwa H, Yoshimatsu K, Araki K, Chayama K, Kumada H, Ogino M, Ebihara H, Murphy ME, Mizutani T, Takashima I, Arikawa J. Detection of hantaviral antibodies among patients with hepatitis of unknown etiology in Japan. Microbiol Immunol 2001; 44:357-62. [PMID: 10888353 DOI: 10.1111/j.1348-0421.2000.tb02506.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Hantaviral antibodies were detected in the sera from patients with hepatic disease of unknown etiology in Japan by several different serological diagnostic methods. A total of 105 sera from diseased patients which were negative to A-G hepatitis virus infections in the Tokyo area were tested. Among them, 3 out of 73 sera from patients with chronic hepatic disease were positive to hantaviral antibody by enzyme-linked immunosorbent assay (ELISA), indirect immunofluorescent antibody assay (IFA) and Western blot analysis (WB). Neutralizing antibody titers of the 3 sera to Seoul virus (SEO) were 4 to 8 times higher than those to Hantaan virus (HTN). However, all of the 32 sera from patients with acute hepatitis were negative for hantaviral antibody. Among the 60 patients with chronic hepatitis in Hokkaido which were serologically negative to B and C hepatitis virus infection, one was positive for hantaviral antibody by ELISA and WB. In contrast, the sera from healthy adults in Japan, 550 from the Honshu and Kyushu regions, and 1,000 from the Hokkaido region, were negative for hantavirus antibody. These results show that hantaviral antibodies are more frequently detected in patients with hepatic disease than in healthy adults. However, the observation that no positive sera were detected from patients with acute hepatitis implies that hantavirus might not be directly related to hepatitis.
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Affiliation(s)
- H Kariwa
- Laboratory of Public Health, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
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Markotić A, Dasić G, Gagro A, Sabioncello A, Rabatić S, Kuzman I, Zgorelec R, Smoljan I, Beus I, Zupanc TA, Dekaris D. Role of peripheral blood mononuclear cell (PBMC) phenotype changes in the pathogenesis of haemorrhagic fever with renal syndrome (HFRS). Clin Exp Immunol 1999; 115:329-34. [PMID: 9933461 PMCID: PMC1905158 DOI: 10.1046/j.1365-2249.1999.00790.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/1998] [Indexed: 11/20/2022] Open
Abstract
Hantaviruses cause an important human illness, HFRS. Blood samples from 22 HFRS-positive, six seronegative patients and 15 healthy controls were examined in 1995, during the largest HFRS epidemic in Croatia. Results of double- and triple-colour immunofluorescence analysis showed an increased percentage of cytotoxic T cells (CD3+CD8+) in seropositive patients compared with seronegatives and healthy controls. The majority of seropositive HFRS patients expressed activation and memory antigens on T and B lymphocytes. The percentage of CD23+ and CD21+ B lymphocytes was lower in seropositive patients. HFRS patients had elevated levels of sCD23 and five had elevated total IgE. The increased expression of both early and late T cell activation antigens, e.g. CD25, CD71 and HLA-DR, memory cells and sCD23 positively correlated with biochemical parameters (AST, ALT, urea, alpha2-globulin) during the acute phase of HFRS. The phenotypic changes observed, especially early and late T cell activation markers, as well as memory cells, could be useful parameters in the evaluation of HFRS course, and prognostic factors of HFRS severity. Additional attention should be paid to liver involvement in the pathogenesis of HFRS.
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Affiliation(s)
- A Markotić
- Institute of Immunology, University Hospital for Infectious Diseases, Zagreb, Croatia
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Yotsuyanagi H, Koike K, Meng G, Yasuda K, Ogata I, Kimura S, Ohkubo A. Acute exacerbation of autoimmune liver disease associated with hantaviral infection. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 1998; 30:81-3. [PMID: 9670364 DOI: 10.1080/003655498750002358] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Hantavirus is known to cause haemorrhagic fever with renal syndrome (HFRS). Although liver dysfunction has been reported in HFRS, hepatic manifestations of hantaviral infection have not been well described. We describe a case of autoimmune cholangitis in which an exacerbation of hepatitis was associated with hantaviral infection. Seroconversion of both IgG- and IgM-class antibodies to hantavirus was noted coincident with acute exacerbation of hepatitis, which was resolved promptly by treatment with corticosteroid. No extrahepatic manifestations were noted. This case suggests that hantavirus may trigger acute exacerbation of autoimmune liver disease without extrahepatic manifestations and that it may cause community-acquired hepatitis.
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Affiliation(s)
- H Yotsuyanagi
- First Department of Internal Medicine, University of Tokyo, Japan
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