Abstract
Fulminant hepatitis is a rare complication of acute hepatitis A virus (HAV) infection. We report three cases of fulminant hepatic failure with death due to HAV infection in patients with pre-existing chronic liver disease. Data from the literature also indicate a high case fatality rate during HAV superinfection in patients with chronic hepatitis B, particularly those with cirrhosis, and in patients with alcoholic cirrhosis. In patients with chronic hepatitis C, results are conflicting with some reports indicating a high fatality rate of HAV superinfection and others not, irrespective of the presence or absence of cirrhosis. Based on our observations and this review of the literature, we suggest that patients with chronic liver disease should be vaccinated against hepatitis A.
Résumé
L’hépatite fulminante est une complication rare de l’infection par le virus de l’hépatite A (VHA). Nous présentons trois cas d’hépatite fulminante due au VHA ayant entraîné le décès de patients atteints d’une maladie hépatique chronique. La recherche documentaire indique également un taux de mortalité élevé en cas de surinfection par le VHA chez les patients souffrant d’hépatite B chronique, et tout spécialement chez ceux atteints d’une cirrhose, ainsi que chez les patients atteints d’une cirrhose alcoolique. Chez les patients souffrant d’hépatite C chronique, les données sont contradictoires car certains rapports indiquent un taux de mortalité élevé dans les cas de surinfection par le VHA et d’autres non, indépendamment de la présence ou de l’absence de cirrhose. Compte tenu de nos observations et après examen de la documentation existante, nous pensons que les patients atteints d’une maladie hépatique chronique devraient tre vaccinés contre l’hépatite A.
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