Korean J Hepatol.  2010 Sep;16(3):295-300. 10.3350/kjhep.2010.16.3.295.

Factors influencing the severity of acute viral hepatitis A

• Kim JI
• Kim YS
• Jung YK
• Kwon OS
• Kim YS
• Ku YS
• Choi DJ
• Kim JH

• KMID: 1717324
• DOI: http://doi.org/10.3350/kjhep.2010.16.3.295

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. (

Keyword

Hepatitis A; Severity; Liver failure; Fulminant

MeSH Terms

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