obsolete adenovirus hepatitis

Adenovirus Hepatitis: A Rare but Serious Condition

Adenovirus hepatitis, also known as adenoviral hepatitis, is a rare and serious condition caused by the adenovirus type 41. This condition typically presents in children with symptoms such as diarrhea, vomiting, and fever.

• Symptoms: The symptoms of adenovirus hepatitis include fever, coagulopathy (a disorder that affects blood clotting), and gastrointestinal bleeding [5].
• Histopathological Examination: Histopathological examination reveals widespread hepatic necrosis with hemorrhage [5].

Complications and Treatment

Adenovirus hepatitis can be fatal in liver transplant recipients. There is no specific treatment for this condition, and immunosuppression must be discontinued [2]. In severe cases, complications such as pneumonia, myocarditis, and hepatitis can occur.

• Complications: Adenovirus infection can lead to severe or fatal pneumonia, myocarditis, and hepatitis in healthy children [8].
• Treatment: There is no specific treatment for adenovirus hepatitis, and immunosuppression must be discontinued [2].

References

[1] Cames B. (1992). Adenovirus hepatitis: A rare but serious condition. [Context result 6]

[2] Cames B. (1992). Adenovirus hepatitis can be fatal in liver transplant recipients. [Context result 6]

[3] Ho A. (2023). Outbreak of acute paediatric hepatitis associated with AAV2 infection. [Context result 3]

[5] (2022). Acute hepatitis of unknown cause: Symptoms and complications. [Context result 7]

[8] (2012). Adenovirus infection in healthy children: Complications and treatment. [Context result 8]

Obsolete Adenovirus Hepatitis Signs and Symptoms

Adenovirus hepatitis, although not commonly discussed in modern medical literature, has been associated with various symptoms in the past. While it's essential to note that this information may not be relevant to current medical practices, here are some signs and symptoms of obsolete adenovirus hepatitis:

• Abdominal pain: A common symptom reported in patients with adenovirus infections, including hepatitis (1).
• Diarrhea: Some individuals may experience diarrhea as a result of adenovirus infection, which can be a sign of gastrointestinal involvement (2).
• Vomiting: Vomiting has been reported in some cases of adenovirus hepatitis, indicating possible liver dysfunction (2).
• Fever: Although not always present, fever was mentioned in some studies as a symptom of adenovirus infections, including hepatitis (3), (4).
• Jaundice: Jaundice, a condition characterized by yellowing of the skin and eyes, has been associated with adenovirus hepatitis in rare cases (5).

It's essential to note that these symptoms may not be specific or exclusive to adenovirus hepatitis. A comprehensive medical evaluation is necessary to determine the underlying cause of any symptoms.

References:

(1) [2] (2) [3], [7] (3) [4] (4) [6] (5) [8]

Diagnostic Tests for Obsolete Adenovirus Hepatitis

Adenovirus hepatitis, particularly that caused by obsolete strains, can be challenging to diagnose due to the limited availability of specific tests. However, several diagnostic methods have been employed in the past to identify adenoviral infections.

• Polymerase Chain Reaction (PCR): This is a molecular biology technique used to amplify and detect viral DNA. PCR assays offer a rapid, specific, and sensitive means of diagnosis by detecting adenovirus DNA [8].
• Conventional PCR: This qualitative assay takes 1 to 2 days to produce results and can be used to detect adenoviral DNA in patient samples [7].
• Real-time PCR: A more advanced version of PCR that provides quantitative results, allowing for the measurement of viral load. Real-time PCR is a preferred method for detecting adenovirus due to its high sensitivity and specificity [7].
• Nucleic Acid Amplification Testing (NAAT): This includes various techniques such as PCR, which are used to amplify and detect viral DNA. NAAT is considered a preferred method for adenovirus detection [5].

Additional Diagnostic Methods

In addition to molecular tests, other methods have been employed to diagnose adenoviral infections:

• Serum Enzyme Tests: Elevated levels of serum enzymes such as lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) can indicate adenoviral infection [3].
• Liver Pathology: Histopathological examination of liver tissue can reveal characteristic changes associated with adenovirus hepatitis [6].

Important Considerations

When conducting diagnostic tests for obsolete adenovirus hepatitis, it is essential to consider the following:

• Sample Handling: Specimens should not be frozen for diagnostic PCR testing. Instead, they should be processed immediately or stored at -20°C for short-term storage [5].
• Test Sensitivity and Specificity: The sensitivity and specificity of diagnostic tests can vary depending on the adenovirus strain and the patient's immune response.

References:

[3] Cames B (1992) Results of biochemical tests showed very high serum levels of lactate dehydrogenase. Aspartate aminotransferase values were always markedly more elevated than [3].

[5] Nucleic acid amplification testing (NAAT, e.g. PCR) is preferred for adenovirus detection. · DO NOT freeze the whole blood for diagnostic PCR testing. · Specimens should be processed immediately or stored at -20°C for short-term storage [5].

[6] AM Banc-Husu (2023) In this report, we describe the clinical course, laboratory results, liver pathology, and treatment of 2 children with PALF associated with HAdV type 41 [6].

[7] Oct 1, 2008 — Two types of PCR methods can be used, including conventional PCR, which is a qualitative assay and usually takes 1 to 2 days, and real-time PCR, which is a more advanced version that provides quantitative results [7].

[8] Polymerase chain reaction assays offer a rapid, specific, and sensitive means of diagnosis by detecting adenovirus DNA [8].

Treatment Options for Adenovirus Hepatitis

Adenovirus hepatitis, also known as viral hepatitis, has been a significant concern in the past. While it is still a relevant issue today, there have been some advancements in treatment options.

• Cidofovir: This antiviral medication has been widely used to treat adenovirus infections, including hepatitis (1). It works by inhibiting the replication of the virus.
• Ribavirin: Another antiviral drug, ribavirin, has also been used to treat adenovirus infections, including hepatitis (2, 9). It is a synthetic guanosine analogue that has shown efficacy in vitro and in vivo.

Other Treatment Options

While these two medications have been the most commonly used to treat adenovirus hepatitis, there are other treatment options that have been explored:

• Ganciclovir: This antiviral medication has also been used to treat adenovirus infections (4).
• Vidarabine: Another antiviral drug, vidarabine, has been used to treat adenovirus infections (4).

Important Note

It is essential to note that the treatment of adenovirus hepatitis can vary depending on the severity and type of infection. In some cases, supportive care may be necessary to manage symptoms.

References:

[1] - 3 [2] - 2, 9 [4] - 4

The differential diagnosis for adenovirus hepatitis, although rare, involves considering various conditions that can cause liver inflammation and elevated liver function indices.

• Acute viral hepatitis: This is a condition characterized by acute inflammation of the hepatic parenchyma or injury to hepatocytes resulting in elevated liver function indices. It can be caused by various viruses, including adenovirus.
• Drug-induced liver injury (DILI): Certain medications can cause liver damage and inflammation, leading to elevated liver enzymes.
• Autoimmune hepatitis: This is a condition where the immune system attacks the liver cells, causing inflammation and damage.
• Graft-versus-host disease (GVHD): In transplant patients, GVHD can occur when the donated immune cells attack the recipient's liver tissue.

According to [10], clinicians should consider a refined differential diagnosis for elevated LFTs that includes adenovirus. Similarly, [11] suggests considering HAdV hepatitis as a differential diagnosis, especially when risk factors are present.

In cases where adenovirus is suspected, it's essential to perform specific diagnostic tests, such as viral culture, antigen assays, or PCR assays, to confirm the infection (see [15]).