Hepatitis A epidemic in the elderly.
BACKGROUND
The purpose of this study was to characterize acute hepatitis A in patients more than 40 years old.


METHODS
Retrospective chart reviews and physician questionnaires were used. Hospitalization, laboratory tests, comorbid conditions, complications, and mortality were assessed.


RESULTS
A total of 180 cases of acute hepatitis A occurred in patients more than age 40. Hospitalization rates increased from 3% for the group aged 40 to 49 to 12% in the group aged 50 to 69 and 42% in those > or = 70 years old. The mean peak total bilirubin value was higher in hospitalized patients than in nonhospitalized patients (12.4 mg/dL vs 7.7 mg/dL). Comorbid conditions included significant alcohol consumption (8%), diabetes (16.6%), cardiovascular disease (54%), and chronic obstructive pulmonary disease (COPD) (21%). Complications included pancreatitis (4.1%), ascites (8.3%), prolonged cholestatic features (7.6%), and death (0.8%).


CONCLUSIONS
Hospitalization rates and rare complications associated with acute hepatitis A increase with age.
Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, 75390-9151, USA.
Geri R
GR
Brown
Kim
K
Persley
D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005260:Female; D006506:Hepatitis A / Q000097:blood / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011517:Prothrombin Time; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013781:Texas / Q000453:epidemiology
D001663:Bilirubin