Acute hepatitis A virus infection without IgM antibodies to hepatitis A virus.

摘要

Background: Hepatitis A virus (HAV) is the leading cause of acute viral hepatitis in industrialized countries. Diagnosis of acute HAV infection is usually based on detection of anti-HAV IgM antibodies, which are present in more than 99% of affected persons at the onset of illness (1).Objective: To describe a case of acute HAV infection in a patient without anti-HAV IgM antibodies.Case Report: A 32-year-old woman with no history of liver disease was hospitalized for deterioration of liver function. Her medical history was unremarkable except for a diagnosis of rheumatoid arthritis 12 years ago, which was treated with several regimens that included a corticosteroid, aurothiopropanol sulfonate, methotrexate, and etanercept. Therapy with these drugs became ineffective and was stopped 1 year ago.