BACKGROUND/AIMS: Hepatitis C virus (HCV) is the most common cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. It is controversial whether HCV causes fulminant hepatitis. METHODOLOGY: To determine the clinical features and etiology of acute hepatitis and fulminant hepatitis in Japan, an endemic area of hepatitis C, between 1986 and 2001 inclusively, a retrospective study of consecutively referred patients was performed. Two hundred and sixty-three patients admitted to a liver clinic after diagnosis of acute hepatitis or fulminant hepatitis, were evaluated. RESULTS: We found 181 cases of acute hepatitis and 82 cases of fulminant hepatitis/late onset hepatic failure. No cases of fulminant hepatitis were positive for HCV RNA. Only three cases had positive anti-HCV antibody, and they were thought to indicate past HCV infection. The main cause of infection in these three patients was hepatitis A virus in one,hepatitis B virus in one, and drugs in the remaining one. HCV did not seem to be the major cause. The three cases died without receiving liver transplantation. CONCLUSIONS: It was revealed that fulminant hepatitis C rarely occurs in Japan, as well as in the USA and European countries. Investigators should search for other causes in fulminant cases presenting an HCV marker.
BACKGROUND/AIMS: Hepatitis C virus (HCV) is the most common cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. It is controversial whether HCV causes fulminant hepatitis. METHODOLOGY: To determine the clinical features and etiology of acute hepatitis and fulminant hepatitis in Japan, an endemic area of hepatitis C, between 1986 and 2001 inclusively, a retrospective study of consecutively referred patients was performed. Two hundred and sixty-three patients admitted to a liver clinic after diagnosis of acute hepatitis or fulminant hepatitis, were evaluated. RESULTS: We found 181 cases of acute hepatitis and 82 cases of fulminant hepatitis/late onset hepatic failure. No cases of fulminant hepatitis were positive for HCV RNA. Only three cases had positive anti-HCV antibody, and they were thought to indicate past HCV infection. The main cause of infection in these three patients was hepatitis A virus in one,hepatitis B virus in one, and drugs in the remaining one. HCV did not seem to be the major cause. The three cases died without receiving liver transplantation. CONCLUSIONS: It was revealed that fulminant hepatitis C rarely occurs in Japan, as well as in the USA and European countries. Investigators should search for other causes in fulminant cases presenting an HCV marker.