J Korean Med Sci.  2014 Feb;29(2):248-253. 10.3346/jkms.2014.29.2.248.

Clinical Characteristics and Outcomes of Acute Hepatitis A in Korea: A Nationwide Multicenter Study

• Kwon SY
• Park SH
• Yeon JE
• Jeong SH
• Kwon OS
• Lee JW
• Kim HS
• Seo YS
• Kim YS
• Sohn JH
• Yim HJ
• Choi JY
• Lee MS
• Kweon YO
• Cheong JY
• Kim HC
• Lee HJ
• Baik SK
• An H
• Byun KS

• KMID: 1789983
• DOI: http://doi.org/10.3346/jkms.2014.29.2.248

Abstract

The aim of this study was to investigate the clinical characteristics of acute hepatitis A during a recent outbreak in Korea. Data of patients diagnosed with acute hepatitis A from 2007 to 2009 were collected from 21 tertiary hospitals retrospectively. Their demographic, clinical, and serological characteristics and their clinical outcomes were analyzed. A total of 4,218 patients (mean age 33.3 yr) were included. The median duration of admission was 9 days. The mean of the highest ALT level was 2,963 IU/L, total bilirubin was 7.3 mg/dL, prothrombin time INR was 1.3. HBsAg was positive in 3.7%, and anti-HCV positive in 0.7%. Renal insufficiency occurred in 2.7%, hepatic failure in 0.9%, relapsing hepatitis in 0.7%, and cholestatic hepatitis in 1.9% of the patients. Nineteen patients (0.45%) died or were transplanted. Complications of renal failure or prolonged cholestasis were more frequent in patients older than 30 yr. In conclusion, most patients with acute hepatitis A recover uneventfully, however, complication rates are higher in patients older than 30 yr than younger patients. Preventive strategies including universal vaccination in infants and active immunization of hepatitis A to adult population should be considered for prevention of community-wide outbreaks of hepatitis A in Korea.

Keyword

Hepatitis A; Morbidity; Mortality

MeSH Terms

Acute Disease
Adolescent
Adult
Age Factors
Aged
Child
Child, Preschool
Cholestasis/epidemiology/etiology
Demography
Hepatitis A/complications/*diagnosis/mortality
Humans
Kidney Failure, Chronic/epidemiology/etiology
Liver Transplantation
Middle Aged
Morbidity
Republic of Korea
Retrospective Studies
Tertiary Care Centers
Young Adult

Figure

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  Fig. 1 Age distribution of hepatitis A patients (n = 4,218).

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  Fig. 2 Distribution of hepatitis A patients (n = 4,218) by month.

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  Fig. 3 Number of acute hepatitis A from data of national surveillance in 2006-2010 in Korea [Reference 16].

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