Abstract

ACUNA, José et al. Hepatitis virales agudas en un hospital de adultos, de 1992 a 2001. Acta méd. costarric [online]. 2003, vol.45, n.4, pp.165-169. ISSN 0001-6002.

Objectives and justification: Due to the change that has been sensed in Costa Rica’s daily clinical practice and confirmed in other countries regarding etiological distribution of acute viral hepatitis, it became clear the need of studying acute viral hepatitis infections, with more interest in the hepatitis A virus because its clinical presentation in adults is more severe tan in children. Methods: All cases of acute AB viral hepatitis were registered, from January 12, 1992 to December 28, 2001 at the Hospital Mexico. The diagnosis was made by detection of IgM anti-HAV, HbsAg and IgM anti-HBc. All cases of fulminant hepatitis from the same period were studied also. The diagnosis and etiology of these cases were based on clinical and laboratory parameters. Results: During the study on period, 587 cases of acute viral hepatitis were diagnosted, 235 by A virus and 352 by B virus, this corresponds to a 40% and 60% respectively. Most of the cases were found between the ages of 20 and 60 years. Fifty three percent of the cases occurred in men and 46,68% in women. Thirty three fulminant hepatitis cases were registered. Forty five percent were caused by viral infection; 33,33% from virus A and 12,12% from virus B. Other pathologies like Wilson disease, hepatotoxicity produced by the use of anesthetics and pregnancy fatty degeneration were found in smaller percentages. Two point fifty six percent of acute viral hepatitis had a fulminant clinical presentation. Four point seven percent of hepatitis Acases had a fulminant course. The management of the patients with acute viral hepatitis was mainly conducted (62%) by the Out-patient Gastroenterology Service. Conclusions: The predominant hepatitis infection in adults was caused by B virus. The etiological distribution was very similar to previous reports made decades ago for specific areas of the country, but the presentation of fulminant hepatitis A has increased (4,7%) considerably. The inclusion of vaccination against hepatitis A virus must be considered in the future of the national health system. This vaccine should be given at birth and applied to young patients and adults with high risk of acquiring severe infection.