Acute Viral Hepatitis, Types A, B and Non-A, Non-B: A Prospective Study of the Epidemiological, Laboratory and Prognostic Aspects in 280 Consecutive Cases

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Abstract
Between September 1977 and October 1978, 280 consecutive cases of acute viral hepatitis in 276 patients (mean age 30.6, range 4–78 years) were seen at a Stockholm hospital for infectious diseases. Serial serum specimens were tested for hepatitis-B surface antigen (HBsAg), and the corresponding antibody (antiHBs); antibody against hepatitis-B core antigen (antiHBc); hepatitis-B e antigen (HBeAg) and the corresponding antibody (antiHBc), and antibodies against hepatitis-A virus (antiHAV) of the IgG and IgM classes. Hepatitis A (HA) was diagnosed in 84 cases (30%), hepatitis B (HB) in 129 cases (46%) and, by exclusion, hepatitis non-A, non-B (NANB) in 63 cases (23%). Four patients had 2 ***consecutive episodes of hepatitis, 2 with HA followed by HB and 2 with HB followed by NANB. Frequently noted epidemiological data of possible significance for viral transmission were, for HA patients, visits abroad (42%) and contacts with a known case of hepatitis (29%) and, for NANB patients, drug addiction (41%) and visits abroad (29%). HB, on the other hand, was as often associated with visits abroad (29%) as with drug addiction (30%) and with contacts with a case of hepatitis (26%). Biochemical investigations showed that HB had a significantly higher, maximum, serum alanine-aminotransferase (S-ALAT) value than HA and NANB (ppppp<0.001 in both). In many cases, however, neither epidemiology nor considerations based on biochemical results could differentiate the various types of hepatitis. At the 3-month follow-up, the S-ALAT values were normalised in 67% of the HA cases and in 65% of the NANB cases but in 89% of the HB cases. At 6 months, the corresponding rates were 93%, 71% and 96%, respectively. 2% of patients with HB and not less than 25% of those with NANB progressed to chronic hepatitis.