Clinical Features of Acute Hepatitis A in the Western Part of Daejeon and Chungnam Province: Single Center Experience

Lee, Tae Hee; Kim, Sun Moon; Lee, Gi Se; Im, Euyi Hyeog; Huh, Kyu Chan; Choi, Yong Woo; Kang, Young Woo

Abstract

BACKGROUND/AIMS: There was an outbreak of hepatitis A in the western part of Daejeon with adjacent Chungnam province in the late 1990's. The aim of this study was to characterize the clinical features and courses of acute hepatitis A in this area. METHODS: A total of 177 cases, who were diagnosed as acute hepatitis A between June 2000 and December 2004, were reviewed retrospectively. CONCLUSIONS: The mean age was 26 and 96% of the cases were under 40 years old. The ratio of male to female was 1.2:1. There were two hospitalized cases in 2000, 3 in 2001, 73 in 2002, 60 in 2003, and 39 in 2004, respectively. The number of diagnosis was most prevalent in June (20.3%). Common occupations were students (62 cases) and homekeepers (21 cases). It was found that 51 patients experienced consumption history of raw fish or shellfish, and that 18 cases had history of exposure to contaminated underground water. Eighteen cases were infected by family members or friends. A history of travel to domestic areas was noted in 31 cases, and to overseas areas in 6 cases (especially Southeast Asia). Only four cases were vaccinated against hepatitis A. HBsAg was positive in 10 cases, and anti-HCV in 2 cases, but none of these had active diseases. The common symptoms were anorexia, jaundice and fatigue. The common ultrasonographic findings were fatty liver (68/157) and acute hepatitis (39/157). In most cases, ALT and total bilirubin level normalized within 8 weeks. No cases of fulminant hepatitis or death were observed. CONCLUSIONS: The majority of cases with acute hepatitis A were completely recovered without sequelae. It is necessary to investigate specific indications for hepatitis A vaccination either in this area or throughout Korea.