Prevalence of hepatitis B and C virus markers in outpatients of Mongolian general hospitals.
Fujioka S. Shimomura H. Ishii Y. Kondo J. Fujio K. Ikeda F. Miyake M. Kusachi S. Tsuji T.
First Department of Internal Medicine, Okayama University Medical School.
In East Asian countries, the prevalence of viral hepatitis has been reported to be high, but precise data for each country remained to be investigated. Here we report the prevalence of viral markers of hepatitis B and hepatitis C in outpatient volunteers visiting two general hospitals in Ulaanbaatar, Mongolia. One hundred fifty sera were tested for HBs antigen (HBsAg), anti-HBs, and anti-HCV by Counting Immunoassay. The backgrounds of groups of patients positive for HBsAg and negative for anti-HCV (group 1; n = 18), negative for HBsAg and positive for anti-HCV (group 2; n = 47), positive for both HBsAg and anti-HCV (group 3; n = 25), and negative for both HBsAg and anti-HCV (group 4; n = 60) were compared. The prevalence of HBsAg, anti-HBs, and anti-HCV in this study group was 28.7%, 39.3% and 48.0%, respectively. Subjects of group 1 (mean +/- SD; 31.3 +/- 12.4 years old) were younger than those of group 4 (39.2 +/- 14.3; p < 0.05), while patients of group 2 (48.7 +/- 15.5) were older than those of group 4 (p < 0.01). More group 2 subjects had histories of jaundice (23/47) than those of group 4 (15/60; p < 0.05). Transaminase levels were higher in group 1 (median (range) IU/l of AST, ALT; 29 (13-95), 32 (9-144) and group 3 (25 (15-187), 22 (8-185)) than in group 4 (18 (9-13), 15 (6-133); p < 0.05, p < 0.005 vs. group 1, and p < 0.005, p < 0.001 vs. group 3, respectively). In HBsAg-negative subjects, those with higher titers of anti-HCV (cut-off index > 15) were older, and had more histories of jaundice and higher levels of AST and ALT than anti-HCV negative subjects (50.3 +/- 14.8 vs. 39.1 +/- 14.3, p < 0.01; 15/28 vs. 15/60, p < 0.01; 22.5 (12-127) vs. 18 (9-93), p < 0.05; 20.5 (7-362) vs. 15 (6-133), p < 0.05; respectively). In conclusion, this preliminary surveillance for hepatitis B and C viral markers showed that both hepatitis viruses are prevalent and may cause liver diseases in Mongolia. A nation-wide survey for these viruses should be urged and preventive measures should be taken to suppress the spread and development of liver diseases in this country.
[Prevalence of human astrovirus serotypes in Shizuoka 1991-96]
Araki K. Kobayashi S. Utagawa E. Kobayashi M. Shinozaki T. Abe T.
Department of Pediatrics, Teikyo University School of Medicine.
A latex agglutination test (LA) for astrovirus types 1-4 detection and typing was used on rotavirus- and adenovirus-negative stool samples from children with diarrhea between 1991 and 1996. Of the 478 samples tested, 30 were identified as astrovirus-positive. Most of the patients with astrovirus infections were under 2 years old. Astrovirus type 1 was the most prevalent serotype; 20/30 (66.7%), followed by type 4 (16.7%), type 3 (13.3%), and type 2 (3.3%). A prevalence of astrovirus-associated diarrhea was observed between January and June each year.
Hepatitis B virus variants in patients with acute hepatitis in whom various clinical forms develop.
Fujise K. Suzuki K. Naito Y. Niiya M. Ishikawa T. Takahashi H. Hoshina S. Saito A. Watanabe R.
Department of Internal Medicine (Kashiwa Hospital), Jikei University School of Medicine, Chiba, Japan.
Ten patients who suffered from acute hepatitis with various clinical forms due to hepatitis B virus (HBV) were studied. HBV variants with a mutation in the precore region were dominant in two patients with fulminant hepatitis and in a patient with the most severe acute hepatitis. However, these mutant viruses were not detected in a patient who had the fulminant form of acute HBV infection on chronic liver damage or in most patients who had severe acute hepatitis. Furthermore, mutant viruses were also not detected in a patient with complicating myopathy and in one who had an atypical clinical course with three transaminase peaks. These results suggest that precore mutants may be involved in the pathogenesis of some cases of severe acute hepatitis, the same as for fulminant hepatitis, but not in other clinical forms of acute hepatitis.
[Sensitivity of Helicobacter pylori to amoxicillin and clarythromycin with special reference to eradication therapy]
Tsuneoka H. Takaba M. Nagatomi Y. Mori K. Matsumoto T. Honda T.
Department of Clinical Laboratory, Yamaguchi-ken Kouseiren Nagato General Hospital.
We isolated strains of Helicobacter pylori from gastric mucosa of patients with peptic ulcer before and after eradication therapy, and studied their sensitivity to amoxicillin (AMPC) and clarythromycin (CAM). Of 85 strains of H. pylori isolated before therapy, MIC90 was 0.025 microgram/ml and no strains were resistant to AMPC. On the other hand, MIC90 of CAM was 0.05 microgram/ml and seven (8.2%) were already resistant to CAM. The H. pylori strains from eight cases of failed eradication therapy with lansoprazole + AMPC remained AMPC sensitive. However H. pylori strains from nineteen cases (82.6%) out of 23 of failed eradication therapy with lansoprazole + CAM became CAM resistant. The situation was similar for the cases of failed eradication therapy with lansoprazole + AMPC + CAM. Drug sensitivity tests prior to eradication therapy are to be recommended. A disc method may be used as a simple alternative to MIC measurement.
Two cases of adult varicella accompanied by hepatic dysfunction.
Muraoka H. Tokeshi S. Abe H. Miyahara Y. Uchimura Y. Noguchi S. Sata M. Tanikawa K.
Department of Medicine, Kumamoto Central Hospital.
Varicella is a typical acute exanthematous viral infection caused by varicella-zoster virus (VZV). In recently years, as far as hepatic dysfunction caused by viruses other than the hepatitis virus is concerned, there have been a few reports on hepatic dysfunction accompanying varicella following organ transplantation of Europe and America and another report on an immunocompromized adult following treatment for Systemic lupus erythematosis (SLE) in Japan. Nonetheless, we searched the MEDLINE and J MEDICINE listing the publications between 1986 and 1996 and found one report on healthy adults with varicella accompanied by hepatic dysfunction in Europe and America and two reports in Japan. Only Noguchi et al. dealt with the findings of liver biopsy. We examined two healthy adults with varicella and mild-to-moderate hepatic dysfunction, and referred to the results of their liver biopsies. The present paper discusses this issue, citing some references.