Publication: The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos
Issued Date
2010-07-01
Resource Type
ISSN
00359203
Other identifier(s)
2-s2.0-77954212655
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Mahidol University
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SCOPUS
Bibliographic Citation
Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.104, No.7 (2010), 475-483
Suggested Citation
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 The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos. Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.104, No.7 (2010), 475-483. doi:10.1016/j.trstmh.2010.03.002 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/29216
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Title
The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos
Author(s)
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
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
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.