散発性急性non-A, non-B型肝炎の検討

Abstract

A preliminary report of acute hepatitis in 1979 suggested that there were a large number of non-B hepatitis. This paper reports the results of further investigations. The patients were admitted to our hospital as acute sporadic viral hepatitis on clinical and biochemical evidence from April, 1976 through October, 1980. Acute and convalescent sera, stored at-20°C, from 66 patients were available for study. Radioimmunoassay was adopted for hepatitis A. R-PHA for HBsAg and radioimmunoassay for IgM specific anti-HBc were chosen for acute hepatitis B. Patients without serological markers of infection to either hepatitis A or B in both acute and convalescent sera were tested for antibody to EB virus. Transfusion-associated hepatitis was excluded.Twenty four of the 66 patients tested had evidence of infection with hepatitis A, 19 were positive for HbsAg, and 3 had IgM-specific anti-HBc in the acute serum. There was no patient with the antibody to EB virus. Thus 20 patients were accepted as having non-A, non-B hepatitis.In non-A, non-B hepatitis the ratio of male to female was 1.2 to 1. Nearly half (9/20) were young adults aged 20 to 29 and there were 2 patients over the age of 60 years. The illness took place through the year and showed a low rate of incidence in the summer. The duration of jaundice was significantly longer than in the patients with hepatitis A (p<0.05) and hepatitis B (p<0.01). A mean of peak serumbilirubin was highest in this form of hepatitis without any significant difference. The abnormal level of GOT continued longer than in hepatitis B (p<0.01). The median peak GOT was higher than in hepatitis A (p<0.01) and lower than in hepatitis B (p<0.05). The median peak TTT was lower than in hepatitis A (p<0.025). Out of the 20 patients 2 became ill in Taiwan and Borneo. There were no addicts and no patients who came in close personal contact with acute non-A, non-B hepatitis. 2 out of 20 showed the prolonged abnormalities of liver function tests in 1.5 and 2.5 years of follow time. It seems reasonable to conclude that acute non-A, non-B hepatitis is severer than acute hepatitis B as judged by duration of jaundice and abnormal GOT level (p<0.01, respectively).