Korean J Gastroenterol.  2014 Jan;63(1):25-31. 10.4166/kjg.2014.63.1.25.

Clinical Features and Risk Factors for Severe Complications among Patients with Acute Hepatitis A Virus Infection in The Jeonbuk Province of Korea

Affiliations
  • 1Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea. ihkimmd@jbnu.ac.kr
  • 2Department of Internal Medicine, Wonkwang University College of Medicine and Hospital, Iksan, Korea.
  • 3Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea.

Abstract

BACKGROUND/AIMS
The frequency of symptomatic acute HAV infections in adulthood are increasing in Korea. This study analyzes the clinical severity in patients with acute HAV infection and investigates risk factors associated with three severe complications: prolonged cholestasis, acute kidney injury, and acute liver failure.
METHODS
We performed a retrospective analysis of 726 patients diagnosed from January 2006 to December 2010 at three tertiary hospitals in Jeonbuk Province, Republic of Korea with acute HAV infection.
RESULTS
In the group of 726 patients, the mean age was 30.3 years, 426 (58.6%) were male, and 34 (4.7%) were HBsAg positive. Severe complications from acute HAV infection occurred as follows: prolonged cholestasis in 33 (4.6%), acute kidney injury in 17 (2.3%), and acute liver failure in 16 (2.2%). Through multivariate analysis, age > or =40 years (OR 2.63, p=0.024) and peak PT (INR) > or =1.5 (OR 5.81, p=0.035) were found to be significant risk factors for prolonged cholestasis. Age > or =40 years (OR 5.24, p=0.002) and female gender (OR 3.11, p=0.036) were significant risk factors for acute kidney injury. Age > or =40 years (OR 6.91, p=0.002), HBsAg positivity (OR 5.02, p=0.049), and peak total bilirubin (OR 1.11, p=0.001) were significant risk factors for acute liver failure.
CONCLUSIONS
Age > or =40 years, female gender, HBsAg positivity, peak PT (INR) > or =1.5, and peak total bilirubin were significant risk factors for severe complications in acute HAV infections.

Keyword

Hepatitis A; Cholestasis; Acute kidney injuries; Acute liver failure; Risk

MeSH Terms

Acute Disease
Acute Kidney Injury/complications
Adult
Cholestasis/complications
Female
Hepatitis A/complications/*diagnosis
Hepatitis B Surface Antigens/blood
Humans
Liver Failure, Acute/complications
Male
Middle Aged
Odds Ratio
Republic of Korea
Retrospective Studies
Risk Factors
Tertiary Care Centers
Hepatitis B Surface Antigens

Reference

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