[Prolonged forms of hepatitis "A"-- clinical and biochemical characteristics].

UNLABELLED Prolonged forms of HAV infection are atypical forms of diseases which occur in up to 24% cases. In clinical mean those forms of disease are described as relapses (recidivisms) and recrudescence. During the three-year multi-centric study we have explored prolonged forms of HAV infection, on two geographically separated and epidemiologically different regions, from every aspect. The purpose of this study, in clinical biochemical sense, was to explore all clinical forms of this disease and determine its biochemical characteristics. This research involved 60 patients with prolonged HAV infection (PTHA) and 30 patients with conventional hepatitis A. During conventional HAV-infection the disease ends in 4 to 8 weeks. Markers of HAV, HBV and HCV infection were determined using ELISA method. Antigen HAV in stool was determined using method of reversed immuno-electro-osmopforesis. Circulating immune complexes was determined photometrical in the sediment poliethylenglicole on rollers length of 450 nm. Research has shown that the PTHA manifests in three clinical forms: recrudescence, relapse and "prolonged hepatitis A from the beginning". All forms of PTHA were often significantly icteric with a clearly shown clinical pictures (p<0.05). Every new disease episode (relapse and/or recrudescence) is in average of smaller intensity than the initial infection. CONCLUSIONS Clinically clear PTHA infection manifests through recrudescence in 66,8 % of cases, through relapse in 26,6 % of cases and "prolonged hepatitis A from the beginning" in 6,6 % of cases. Recrudescence appears significantly often one time rather than two or more times (p<0.001). Relapse never appeared:after recrudescence, and it was not noted more than once. "Prolonged forms of disease from the beginning" could represent relapse/recrudescence whose initial disease phase remained sub clinic. Average duration of PTHA is five times longer than in the control group. Men tend to fall ill from PTHA twice as much as woman.