[Viral hepatitis A-E]. / Virushepatitis A­E.

Hepatitis viruses A-E cause acute and chronic liver inflammation and thus lead to significant morbidity and mortality worldwide. They differ significantly in their biology, course of disease and therapy options. While hepatitis A virus only causes acute infection, hepatitis B can become chronic, even reactivate or occur as coinfection with hepatitis D virus. Whereas these infections are preventable through vaccination, a vaccine does not exist against HCV. However, new direct antiviral agents reliably lead to cure of chronic hepatitis C. Hepatitis E virus frequently causes acute or-in case of immunosuppression-even chronic hepatitis. Continual screening of patients with elevated liver enzymes or risk groups using simple serological markers can enable virus-specific therapy of mostly asymptomatic chronic virus hepatitis, preventing the development of liver cirrhosis and hepatocellular carcinoma.

Falla hepática aguda sobre crónica: análisis de una serie de casos y revisión de la literatura / Acute-on-chronic liver failure: analysis of a case series and review of the literature

Introducción. La cirrosis hepática continúa siendo una enfermedad frecuente en nuestro medio, con una mortalidad elevada. Su descompensación se puede asociar a la falla de uno o más órganos, llevando a una falla hepática aguda sobre crónica (ACLF), confiriéndoles a estos pacientes un pronóstico diferente asociado a una alta mortalidad. El objetivo de este artículo es reportar las características clínicas y epidemiológicas de los pacientes que cursaron con ACLF en un hospital de alta complejidad, así como realizar una revisión de la literatura de acuerdo con las definiciones actuales, sobre las diferentes escalas para la evaluación de su pronóstico. Metodología. Estudio descriptivo tipo retrospectivo de series de casos. La población estuvo constituida por la totalidad de los pacientes atendidos en el periodo entre diciembre del 2005 a enero del 2020, mayores de 18 años, y con diagnóstico de cirrosis hepática en el Hospital Pablo Tobón Uribe, que cumplieran los criterios diagnósticos para ACLF. Resultados. Se incluyó una serie de casos de 19 pacientes con diagnóstico de ACLF, el 47,36% correspondía a hombres con una mediana de edad de 53 años, la clasificación de la cirrosis fue Child C para todos, la etiología fue de origen alcohólico en el 42,10%, autoinmune en el 21,05%, virus de la hepatitis B en el 10,52%, y virus de la hepatitis C, esteatohepatitis no alcohólica y cirrosis biliar primaria en el 5,26% de los casos. Los precipitantes de la ACLF fueron alcoholismo activo en el 42,10% de los casos, no se identificó evento en el 26,31%, y las infecciones y sangrado variceal se presentaron en el 15,78%. Ladistribución de la clasificación fue ACLF 1 15,78%, ACLF 2 26,31% y ACLF 3 36,84%. La supervivencia acumulada en los pacientes que recibieron trasplante hepático fue mayor en relación a los que no, 80% versus 33,3%. Conclusión. La ACLF es un proceso dinámico y potencialmente reversible con una mortalidad elevada a corto plazo. En nuestra serie encontramos una mayor supervivencia en los pacientes trasplantados, lo que confiere una mejoría en la sobrevida a corto y largo plazo, por lo que este continúa siendo el tratamiento óptimo en la actualidad.

Introduction. Liver cirrhosis continues to be a common disease in our setting, with high mortality. Its decompensation can be associated with the failure of one or more organs, leading to acute-onchronic liver failure (ACLF), giving these patients a different prognosis associated with higher mortality. The objective of this article is to report the clinical and epidemiological characteristics of patients with ACLF in a high-complexity hospital, as well as to carry out a review of the literature about the different scores for evaluating their prognosis. Methodology. This is a descriptive, retrospective case series study. The population included all the patients during December 2005 to January 2020, over 18 years old, with a diagnosis of liver cirrhosis at the Pablo Tobón Uribe Hospital, who met the diagnostic criteria for ACLF. Results. We included a case series of 19 patients with a diagnosis of ACLF, 47.36% were men with a median age of 53 years, all of them with Child C cirrhosis, the etiology was alcoholic in 42.10%, autoimmune in 21.05%, hepatitis B virus in 10.52%, and hepatitis C virus, non-alcoholic steatohepatitis and primary biliary cirrhosis in 5.26% of the cases. The precipitants of ACLF were active alcoholism in 42.10% of the cases, no event was identified in 26.31%, and variceal infections and bleeding occurred in 15.78%. Classification was ACLF 1 in 15.78%, ACLF 2 in 26.31% and ACLF 3 in 36.84%. Cumulative survival in patients who received liver transplantation was higher in relation to those who did not, 80% versus 33.3%. Conclusion. ACLF is a dynamic and potentially reversible process with high short-term mortality. In our series, we found a longer survival in transplant patients, which improves survival rates at short and long term, so as of today, this continues to be the optimal treatment.

A Case of Imported Dengue Fever with Acute Hepatitis / 대한간학회지

Dengue fever is an acute febrile disease caused by the dengue virus, which belongs to the flaviviridae family, and this virus is transmitted by the bite of the mosquito Aedes aegypti. It occurs in the tropical climates of the South Pacific, Southeast Asia, India, Africa and the subtropical zone of America. Imported cases of Dengue fever and Dengue hemorrhagic fever are rapidly increasing as many Koreans are now traveling abroad. Liver injury is usually detected by laboratory investigation according to a surveillance protocol. Although liver injury by dengue virus has been described in Asia and the Pacific islands, the pathogenic mechanisms are not yet fully clarified. It is usually expressed in a self-limiting pattern and the patient has a complete recovery. We report here on a case of a young woman who presented with general weakness, nausea and significant elevation of the aminotransferase levels, and she was diagnosed with dengue fever.