Clinical characteristics and outcomes of acute hepatitis a in Korea: a nationwide multicenter study.

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.