Characterization and Investigation of Risk Factors for Late-Relapsing Hepatitis After Yellow Fever.
Characterization and Investigation of Risk Factors for Late-Relapsing Hepatitis After Yellow Fever.
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DOI：
10.1093/cid/ciad249
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发表时间：
2023-08-22
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影响因子：
--
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中科院分区：
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在巴西最近爆发的黄热病暴发期间，描述了疾病恢复期的黄热病后晚期复发肝炎(LHep-YF)。LHEP-YF的特点是肝酶在YF症状开始后46-60天左右出现反弹和非特异性的临床表现。在这里，我们使用2017-2018年间在巴西存活的具有代表性的YF患者队列数据，描述了LHep-YF的临床病程和风险因素。共有221名YF阳性患者从米纳斯吉拉斯州的传染病参考医院出院，并在症状出现后30、45和60天进行了随访。从发病后46天到60天，16%的YF患者(n=36/221)的转氨酶(门冬氨酸氨基转移酶或丙氨酸氨基转移酶>；500IU/L)、碱性磷酸酶和总胆红素水平出现反弹。其他肝脏炎症的病因，如感染性肝炎、自身免疫性肝炎和代谢性肝病被排除。黄疸、乏力、头痛和低血小板水平与LHep-YF相关。人口学因素、临床表现、实验室检查、超声检查和YF急性期的病毒载量与LHep-YF的发生无关。这些发现为YF恢复期晚期复发肝炎的临床病程提供了新的数据，并强调了在急性YF后延长患者随访的必要性。黄热病后晚期复发性肝炎是在急性黄热期后60天左右描述的一种临床表现，表现为非特异性症状，如转氨酶、碱性磷酸酶和总胆红素值乏力和反弹，最终结果良好。
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. 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. 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. 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. Late-relapsing hepatitis after yellow fever is a clinical picture described around 60 days after the acute yellow fever phase, presenting with nonspecific symptoms, such as fatigue and rebound in aminotransferases, alkaline phosphatase, and total bilirubin values, with a benign final outcome.
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影响因子：
3.8
作者：
Sacchetto L;Drumond BP;Han BA;Nogueira ML;Vasilakis N
通讯作者：
Vasilakis N
影响因子：
4.7
作者：
Rezende, Izabela Mauricio;Pereira, Leonardo Soares;Drumond, Betania Paiva
通讯作者：
Drumond, Betania Paiva
DOI：
10.1016/s1473-3099(01)00016-0
发表时间：
2001-08-01
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Monath, T P
通讯作者：
Monath, T P
影响因子：
3.8
作者：
Costa-Pereira, Christiane;Campi-Azevedo, Ana Carolina;Martins-Filho, Olindo Assis
通讯作者：
Martins-Filho, Olindo Assis
影响因子：
29.4
作者：
Kim WR;Mannalithara A;Heimbach JK;Kamath PS;Asrani SK;Biggins SW;Wood NL;Gentry SE;Kwong AJ
通讯作者：
Kwong AJ