Factors influencing the severity of acute viral hepatitis A.
10.3350/kjhep.2010.16.3.295
- Author:
Joo Il KIM
1
;
Yun Soo KIM
;
Young Kul JUNG
;
Oh Sang KWON
;
Yeon Suk KIM
;
Yang Suh KU
;
Duck Joo CHOI
;
Ju Hyun KIM
Author Information
1. Department of Internal Medicine, Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea. kimys@gilhospital.com
- Publication Type:Original Article
- Keywords:
Hepatitis A;
Severity;
Liver failure;
Fulminant
- MeSH:
Acute Disease;
Adult;
Age Factors;
Alcohol Drinking;
Female;
Hepatitis A/complications/*diagnosis;
Hepatitis B Surface Antigens/blood;
Hepatitis B, Chronic/complications;
Humans;
Liver Failure, Acute/epidemiology/etiology;
Male;
Middle Aged;
Predictive Value of Tests;
Prothrombin Time;
Retrospective Studies;
Severity of Illness Index
- From:The Korean Journal of Hepatology
2010;16(3):295-300
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Most patients with acute viral hepatitis A have a favorable course, but a few of them suffer from severe forms of hepatitis such as fulminant hepatitis. This study was carried out to identify the factors influencing the severity of acute viral hepatitis A. METHODS: We retrospectively reviewed the medical records of 713 patients with acute hepatitis A, who were divided into two groups: severe hepatitis A (N=87) and non-severe hepatitis A (N=626). Severe hepatitis was defined as fulminant hepatitis or prolongation of prothrombin time (INR> or =1.5). Clinical variables were compared between the two groups. RESULTS: The incidence of fulminant hepatitis was 1.4 % (10/713) in patients with acute hepatitis A. Thirty-three (4.6 %) cases exhibited HBsAg positivity. In multivariate analyses, significant alcohol intake and the presence of HBsAg were significant predictive factors of fulminant hepatitis A, and significant alcohol intake and age were significant predictive factors of severe hepatitis A. HBeAg and HBV-DNA status did not affect the clinical course of hepatitis A in chronic hepatitis B carriers. CONCLUSIONS: While most patients with acute hepatitis A have an uncomplicated clinical course, our data suggest that a more-severe clinical course is correlated with being older, significant alcohol intake, and chronic hepatitis-B-virus infection. (
