Comparison of clinical manifestations and epidemiology between acute hepatitis A and acute hepatitis E in Taiwan.
OBJECTIVE
Acute hepatitis A (AHA) and acute hepatitis E (AHE) are endemic in developing countries. They share similar transmission routes and clinical manifestations. To compare the differences in epidemiology, clinical picture and prognosis between these two enterically transmitted forms of hepatitis, we enrolled 58 consecutive AHA or AHE patients (42 men and 16 women; age 16-74 years) from January 1990 to April 2001.


RESULTS
In comparison to AHA, patients with AHE were older (56.2 +/- 15.4 vs 30.7 +/- 11.0 years, P < 0.0001), and more frequently had a history of travel within 3 months before onset of illness (68.8 vs 30.8%, P = 0.003). In laboratory data, AHE patients had lower serum levels of albumin (3.4 +/- 0.4 vs 3.8 +/- 0.4 g/dL, P = 0.016), alanine aminotransferase (1912 +/- 1587 vs 3023 +/- 1959 U/L, P = 0.015), and aspartate aminotransferase (1681 +/- 1444 vs 2374 +/- 2869 U/L, P = 0.24), but a higher serum bilirubin level (17.8 +/- 12.3 vs 8.7 +/- 5.0 mg/dL, P = 0.003) than AHA patients. Moreover, five (15.6%) patients with AHE compared with none with AHA died. This probably indicates that AHE had a worse outcome than AHA in our study. In analysis of epidemiological factors, older age of onset of illness was the only significant predicator of outcome. From an epidemiological survey, most AHE patients were imported while most AHA patients were not. However, native AHE and imported AHA did occur in Taiwan.


CONCLUSIONS
Patients with AHE in Taiwan had older age of onset, more records of traveling history, and poorer clinical manifestations than those with AHA, and age seemed to be the most important factor to influence outcome.
Su
Chien-Wei
CW
Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.
Wu
Jaw-Ching
JC
Huang
Yi-Shin
YS
Huo
Teh-Ia
TI
Huang
Yi-Hsiang
YH
Lin
Chen-Chun
CC
Chang
Full-Young
FY
Lee
Shou-Dong
SD
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D003627:Data Interpretation, Statistical; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology*; D016751:Hepatitis E / Q000453:epidemiology*; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology