Characterization and Investigation of Risk Factors for Late-Relapsing Hepatitis After Yellow Fever
Year: 2023
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Late-relapsing hepatitis after yellow fever (LHep-YF) during the convalescent phase of the disease has been described during recent yellow fever (YF) outbreaks in Brazil. LHep-YF is marked by a rebound in liver enzymes and nonspecific clinical manifestations around 46-60 days after YF symptom onset. METHODS: Here we have characterized the clinical course and risk factors for LHep-YF using data from a representative cohort of patients who survived YF in Brazil, 2017-2018. A total of 221 YF-positive patients were discharged from the infectious disease reference hospital in Minas Gerais and were followed up at 30, 45, and 60 days post-symptom onset. RESULTS: From 46 to 60 days post-symptom onset, 16% of YF patients (n = 36/221) exhibited a rebound of aminotransferases (aspartate aminotransferase or alanine aminotransferase >500 IU/L), alkaline phosphatase, and total bilirubin levels. Other etiologies of liver inflammation such as infectious hepatitis, autoimmune hepatitis, and metabolic liver disease were ruled out. Jaundice, fatigue, headache, and low platelet levels were associated with LHep-YF. Demographic factors, clinical manifestations, laboratory tests, ultrasound findings, and viral load during the acute phase of YF were not associated with the occurrence of LHep-YF. CONCLUSIONS: These findings provide new data on the clinical course of Late-relapsing hepatitis during the convalescent phase of YF and highlight the need for extended patient follow-up after acute YF.
Source: Clinical Infectious Diseases
DOI: 10.1093/cid/ciad249
Authors: Izabela Mauricio de Rezende, Max A McClure, Leonardo S Pereira, Jordana R B Fradico, Adriana R C Cenachi, Alexandre S Moura, Luísa L de A Paladino, Maria Rita T Dutra, Pedro A Alves, Marcelo A P Xavier, Rodrigo F do C Said, Dario B Ramalho, Thaysa D P Gama, Olindo A Martins-Filho, Thomas P Monath, Andréa Teixeira-Carvalho, Betânia P Drumond, Angelle D LaBeaud, for the Yellow Fever Collaborative Group, Alexandre Maurício Castro Bragato, Argus Leão Araújo, Flávio Augusto de Almeida Faria, Indiara Penido, Letícia Menezes, Livia Frota Rabelo, Livia Pamplona, Lívia Fulgêncio da Cunha Melo, Lívia Soares Coelho Fonte Boa, Lívia Zignago Moreira dos Santos, Ludmila de Paula, Marcelle Cardoso Marçal, Natalia Soares Albuquerque, Rodrigo Macedo, Tayrine Araújo
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,320
Funders: National Multiple Sclerosis Society Michigan Chapter, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Fundação de Amparo à Pesquisa do Estado de Minas Gerais, Ministério da Saúde, Fundação Oswaldo Cruz, National Institutes of Health, National Institute of Allergy and Infectious Diseases
OpenAlex ID: W4367048106