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Title: The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos
Authors: Bounkong Syhavong
Bouachanh Rasachack
Lee Smythe
Jean Marc Rolain
Anne Marie Roque-Afonso
Kemajittra Jenjaroen
Vimone Soukkhaserm
Simmaly Phongmany
Rattanaphone Phetsouvanh
Sune Soukkhaserm
Te Thammavong
Mayfong Mayxay
Stuart D. Blacksell
Eleanor Barnes
Philippe Parola
Elisabeth Dussaix
Didier Raoult
Isla Humphreys
Paul Klenerman
Nicholas J. White
Paul N. Newton
Mahosot Hospital
Queensland Health
Faculte de Medecine de Marseille Universite de la Mediterranee
Hopital Paul-Brousse
Mahidol University
University of Oxford
National Blood Transfusion Centre
University of Health Sciences
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Jul-2010
Citation: Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.104, No.7 (2010), 475-483
Abstract: There is little information on the diverse infectious causes of jaundice and hepatitis in the Asiatic tropics. Serology (hepatitis A, B, C and E, leptospirosis, dengue, rickettsia), antigen tests (dengue), PCR assays (hepatitis A, C and E) and blood cultures (septicaemia) were performed on samples from 392 patients admitted with jaundice or raised transaminases (≥×3) to Mahosot Hospital, Vientiane, Laos over 3 years. Conservative definitions suggested diagnoses of dengue (8.4%), rickettsioses (7.3%), leptospirosis (6.8%), hepatitis B (4.9%), hepatitis C (4.9%), community-acquired septicaemia (3.3%) and hepatitis E (1.6%). Although anti-hepatitis A virus (HAV) IgM antibody results suggested that 35.8% of patients had acute HAV infections, anti-HAV IgG antibody avidity and HAV PCR suggested that 82% had polyclonal activation and not acute HAV infections. Scrub typhus, murine typhus or leptospirosis were present in 12.8% of patients and were associated with meningism and relatively low AST and ALT elevation. These patients would be expected to respond to empirical doxycycline therapy which, in the absence of virological diagnosis and treatment, may be an appropriate cost-effective intervention in Lao patients with jaundice/hepatitis. © 2010 Royal Society of Tropical Medicine and Hygiene.
ISSN: 00359203
Appears in Collections:Scopus 2006-2010

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