on the path to DISCOVERY OF HEPATITIS E
CHRONIC LIVER DISEASE AFTER NON-A, NON-B HEPATITISBy : KHUROO MEHNAAZ Dated : 11/26/2018
KHUROO MS. CHRONIC LIVER DISEASE AFTER NON-A, NON-B HEPATITIS. LANCET 1980; ii (8199):860-861 PMID: 6105287
CHRONIC LIVER DISEASE AFTER NON-A, NON-B HEPATITIS
Sir, - In our one year follow-up (July 12) on patients with non-A, non-B (NANB) hepatitis on which detailed epidemiological, clinical, biochemical, pathological, and antigen data are reported elsewhere (Am J Med 1980;68:818). NANB hepatitis was diagnosed by serological exclusion of HBsAg (passive haemagglutination), anti-HBc (counter-electrophoresis), and anti-HAV IgM (radioimmunoassay and ELISA) in acute phase sera. At follow-up all patients were tested for HBsAg (CEP0 to exclude the development of hepatitis B in the intervening period. Dr, Khardori’s comments (August 16, p. 365) have been written without reference to our Am J Med paper. We did not diagnose NANB hepatitis by exclusion of HBsAg (CEP0 but used very sensitive methods to exclude hepatitis A and B. Chronic hepatitis has been defined as unexplained persistence of an abnormal transaminase level for more than 20 weeks after acute hepatitis, and only such patients need liver biopsies further to classify chronic hepatitis into chronic persistent and chronic active hepatitis.1 In our follow-up data, 4 cases showed unexplained persistence of abnormal transaminase levels and could have had chronic hepatitis. As these enzyme levels can fluctuate, serial estimations of SGPT were done in 30 cases to exclude this possibility. 5 cases with normal enzyme levels have had repeat liver biopsies and these showed normal liver histology. With these data we believe that the incidence of chronic hepatitis following non-parenteral NANB is very low and does contrast with the data following post-transfusion NANB hepatitis.2
Department of Medicine, MedicalCollege, Srinagar, Kashmir, India-190010
MOHAMMAD SULTAN KHUROO
1. Koretz et al. Post-transfusion chronic liver disease. Gastroenterology 1976;71:797-802. 2. Knodell RG, Conrad ME, Ishaq KG. Development of chronic liver disease after acute non-A, non-B post-transfusion hepatitis. Role of globulin prophylaxis in its prevention. Gastroenterology 1977;72:902-09.