Unusual Features of Viral Hepatitis in Accra, Ghana

Abstract

A study of viral hepatitis undertaken in Accra, Ghana, where it is a common and severe endemic disease, revealed several unusual clinical and histopathologic features. Histopathologic examination of the liver biopsy sections from 136 patients revealed a distinctive pattern characterized by a "glandular" transformation of hepatocytes, a high frequency of cholestasis, and a rarity of acidophilic bodies. Pregnant women had a higher complication rate than nonpregnant women and had a high fetal death rate. Patients had twice the expected frequency of erythrocytic G-6-PD deficiency, and those with the enzyme defect had a more prolonged and severe course. Jaundice was more prolonged in men than woman and in the old than young. The high acute coma and death rates were associated with immigration, lower economic standing, and pregnancy. Prolonged jaundice, on the other hand, could be attributed to inherent biological factors such as age, sex, and G-6-PD deficiency.