Long Term Follow-Up Studies of Patients Surviving Fulminant Viral Hepatitis

Abstract

Long term follow-up studies (3 to 46 months) were conducted in 22 patients who had survived severe acute viral hepatitis with coma. Complete clinical and biochemical resolution of the hepatitis was observed in all patients within 45 to 75 days after the onset of the acute hepatitis. The only identifiable sequela of the fulminant episode was the persistence of hepatitis B antigen in 1 of 16 initially hepatitis B antigen-positive patients. Three patients suffered a second attack of acute viral hepatitis 4 to 10 months after recovery from the fulminant episode. Mild unresolved hepatitis followed the second episode in 1 patient. Follow-up liver biopsy made in 13 patients (2 to 37 months after the fulminant episode) showed no liver disease related to the fulminant hepatitis except for mild unresolved hepatitis in the hepatitis B antigen carrier. It appears that patients surviving fulminant viral hepatitis rarely, if ever, develop chronic liver disease, in spite of the extreme degrees of hepatic necrosis occurring during the acute illness.