ACUTE SPORADIC NON-A, NON-B, NON-C, NON-D, NON-E HEPATITIS

Patients presenting with clinical and laboratory features consistent w ith a diagnosis of acute non-A, non-B hepatitis were evaluated for evi dence of hepatitis C or hepatitis E infection and for evidence of seve re or prolonged disease, Antibody to hepatitis C virus (anti-HCV) was detected in 75 of 108 (69%) patients, antibody to hepatitis E virus (a nti-HEV) in three patients (3%), and neither antibody in 31 (29%) pati ents, One patient had both anti-HCV and anti-HEV. HCV RNA was not dete cted in sera from any of 20 patients with seronegative (non-ABCDE) hep atitis, but in all 10 patients with anti-HCV who mere tested by polyme rase chain reaction (PCR), Compared with patients with acute hepatitis C, those with non-ABCDE hepatitis had a lower incidence of parenteral risk factors (6% vs, 70%; P < .001), higher peak serum bilirubin leve ls (45% vs. 5% with peak levels > 15 mg/dL; P < .001), more prolonged jaundice (25% vs, 0% with peak bilirubin >5 weeks after onset; P < .01 ), more severe prothrombin time abnormalities (26% vs, 0% with >3 seco nd prolongation; P < .001), more severe hypoalbuminemia (39% vs. 9% wi th albumin <3 g/dL P < .01), and more frequent major clinical complica tions (13% vs. 0% with encephalopathy; P < .01; 10% vs. 0% with death or transplant; P = .024), Patients with acute non-ABODE hepatitis were less likely to develop chronic hepatitis than those with acute hepati tis C (23% vs, 68%; P < .05). Thus, patients with acute non-ABCDE hepa titis are epidemiologically distinct from those with acute hepatitis C and have a significantly more severe acute illness.