Late-Relapsing Hepatitis after Yellow Fever

Autor: Indiara Penido, Tayrine Araujo Santos, Andréa Marques Vieira da Silva, Izabela Maurício de Rezende, Natalia Soares Albuquerque, Elaine Speziali, Betânia Paiva Drumond, Leonardo Soares Pereira, Erna Geessien Kroon, Pedro Augusto Alves, Carlos Eduardo Calzavara, Lívia Zignago Moreira Dos Santos, Ana Paula Dinis Ano Bom, Marcelo Antônio Pascoal Xavier, Andréa Teixeira-Carvalho, Olindo Assis Martins-Filho, Camilla Bayma Fernandes, Ana Carolina Campi-Azevedo, Jordana Rodrigues Barbosa Fradico
Rok vydání: 2020
Předmět:
Zdroj: Viruses
Viruses, Vol 12, Iss 2, p 222 (2020)
ISSN: 1999-4915
Popis: One patient presented hyporexia, asthenia, adynamia, and jaundice two months after acute yellow fever (YF) onset; plus laboratory tests indicating hepatic cytolysis and a rebound of alanine and aspartate transaminases, and total and direct bilirubin levels. Laboratory tests discarded autoimmune hepatitis, inflammatory or metabolic liver disease, and new infections caused by hepatotropic agents. Anti-YFV IgM, IgG and neutralizing antibodies were detected in different times, but no viremia. A liver biopsy was collected three months after YF onset and tested positive for YFV antigens and wild-type YFV-RNA (364 RNA-copies/gram/liver). Transaminases and bilirubin levels remained elevated for five months, and the arresting of symptoms persisted for six months after the acute YF onset. Several serum chemokines, cytokines, and growth factors were measured. A similar immune response profile was observed in the earlier phases of the disease, followed by more pronounced changes in the later stages, when transaminases levels returned to normal. The results indicated viral persistence in the liver and continual liver cell damage three months after YF onset and reinforced the need for extended follow-ups of YF patients. Further studies to investigate the role of possible viral persistence and the immune response causing relapsing hepatitis following YF are also necessary.
Databáze: OpenAIRE
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