Prevalence of leptospira in acute hepatitis syndrome and assessment of IL-8 and TNF-alpha level in leptospiral hepatitis

Author: Rizvi M   Azam M   Ajmal M R   Shukla I   Malik A  

Publisher: Maney Publishing

ISSN: 1364-8594

Source: Annals of Tropical Medicine and Parasitology, Vol.105, Iss.7, 2011-10, pp. : 499-506

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Abstract

To study the prevalence of leptospira in acute hepatitis syndrome and to assess interleukin (IL)-8 and tumour necrosis factor (TNF)-alpha levels in the pathogenesis of hepatitis due to leptospiral infection. Two hundred and forty-seven consecutive cases with symptoms of acute hepatitis and 30 healthy controls were enrolled in the study and detailed clinical history was elicited from them. Enzyme-linked immunosorbent assays (ELISAs) for HAV, HBV, HCV and HEV were performed to rule out common viral aetiology of hepatitis. IgM antibodies to leptospira were detected by ELISA. IL-8 and TNF-alpha levels were estimated in leptospira-positive cases and healthy controls by ELISA. Out of 247 cases of acute hepatitis, 46 (18·62%) were observed to be positive for IgM antibodies for leptospira. The mean age of these patients was 31·99±0·28 years (25 males and 21 females; M/F ratio: 1·19:1). The mean ALT, AST and ASP were raised in the majority of patients. IL-8 was found to be elevated (130·81 pg/ml) in a large majority of cases 41/46, 89·1% (P</i><0·001). patients="" with="" more="" severe="" symptoms="" were="" associated="" with="" higher="" levels="" of="" il-8.="" one="" mortality="" was="" observed="" due="" to="" leptospira.="" unpredictably,="" tnf-alpha="" level="" was="" largely="" suppressed="" (45·63="" pg/ml)="" in="" most="" of="" the="" leptospira-positive="" patients="" in="" comparison="" with="" healthy=""></0·001).> Leptospira-induced hepatitis should be actively looked for in patients negative for A?E viral hepatitis. IL-8 appears to play an important role in the pathogenesis of leptospiral hepatitis. High TNF-alpha should alert clinicians for aggressive in hospital management of patients.