Prolonged Cholestasis in Patient with Acute HAV Infection

Abstract

Background: Hepatitis A virus (HAV) is a virus which infects yearly more than 1.5 million persons worldwide and is usually spread through contaminated food and water. Most HAV infection in children under the six years of age are asymptomatic and they develop lifelong immunity. However, HAV infection in older children and adults often symptomatic with development of jaundice, nausea, vomiting, poor appetite, fever, fatigue, abdominal pain, etc. most of those infected patients usually fully recovering from HAV infection naturally within 2 months, it has not been a cause for major concern of public health). With more and more patients suffering from hepatitis A, there is also increase in the number of patients suffering from unusual presentation of HAV infection also. Most hepatitis A patients tend to recover from the illness natural without any complications; however, there are occasions of serious complications among adult hepatitis A patients such as extrahepatic manifestation, acute renal failure, cholestatic hepatitis, relapsing hepatitis, prolonged course and even fulminant hepatic failure. Cholestatic hepatitis accounts for between 0.8 - 5.2% of hepatitis. Together with increasingly more cases of hepatitis A being reported, the number of patients who have cholestatic hepatitis arising from hepatitis A also has increased. The current treatment for hepatitis A is usually symptomatic treated by sufficient nutrition, vitamin supply and sufficient rest. There are also no special treatments for cholestatic hepatitis, with conservative treatment being used. Ursodeoxycholic acid (UDCA) and cholestyramine and antihistamines are used to treat skin itching caused by cholestatic hepatitis; however, there are occasions where symptoms of cholestatic hepatitis are so severe and prolong that required the use of corticosteroids to shorten the duration of symptoms and reduce hospitalization.as to call for liver transplantation. Aim: Is to show the effectiveness of corticosteroids in shorten the duration of severe symptoms and shorten hospitalization in patient with prolong severe cholestatic symptoms of acute hepatitis A virus infection.