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Relationships between luetic infection and acute viral hepatitis

Abstract number: p777

Botgros  R.F., Popescu  C.P., Florescu  S-A., Nicolescu  A.M., Cotiga  M., Raduta  L., Calistru  P.I., Ceausu  E.

Background: 

Acute viral hepatitis (AVH) still represents one of the major problems for the romanian healthcare system. The association between lues and AVH is currently underdiagnosed and represents a problem which should be more focused in future.

Methods: 

Retrospective clinical study of 469 acute viral hepatitis patients admitted in our hospital in 2004. The diagnosis of coexisting lues was made by an association of positive values of Treponema screening tests (i.e. qualitative RPR and VDRL) and of a confirmation test (we used TPHA).

Results: 

Out of the 469 patients, 330 (70.4%) were diagnosed with acute HAV hepatitis, 116 (24.7%) with acute HBV hepatitis, 8 (1.7%) with acute HDV hepatitis on a chronic HBV infection background, 3 (0.6%) had an HAV+HBV acute coinfection, 2 (0.4%) had an HBV+HDV acute coinfection. The aetiology of the acute hepatitis remained unclear in 10 (2.1%) of the patients, but was presumed viral based on the clinical presentation and evolution and on the associated performed lab tests. TPHA was performed in a total of 62 (13.2%) of the admitted patients, and was positive in 8 (1.7% overall, 12.9% of all TPHA tests performed) cases. All positive TPHA tests were accompanied by positive lues screening tests (qualitative RPR (qRPR) tests (7 positive tests out of 27 performed, overall positivity 1.5% and a positivity of 25.9% with regard to the total qRPR tests performed) and VDRL test [one positive test out of three performed, overall positivity 0.2% and a positivity of 33.3% with regard to the total VDRL tests performed)] which allowed the physicians to diagnose lues in addition to the AVH. The distribution of lues among the eight diagnosed patients with regard to the AVH aetiology was as follows: one case coexisted with HAV AVH, five were associated to HBV AVH, one case was discovered in addition to HBV+HDV AVH on a chronic HCV infection background and one case coexisted with HDV AVH on a chronic HBV infection background.

Conclusions: 

(1) The association between lues and AVH should be searched for, especially in those patients with parenterally transmitted viral infections. (2) We estimate that by routinely searching for luetic infection in AVH patients, a certain number of currently undiagnosed lues cases may become apparent and may be appropriately treated. (3) We therefore suggest the TPHA testing in documented parenterally transmitted acute viral hepatitis cases, and, if positive, the further testing with any available Treponema screening test.

Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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