Does chronic hepatitis B infection affect the clinical course of acute hepatitis A?
The impact of chronic hepatitis B on the clinical outcome of acute hepatitis A remains controversial. The aim of present study was to evaluate the clinical characteristics of acute hepatitis A in cases with underlying chronic hepatitis B compared to cases of acute hepatitis A alone. Data on 758 patients with acute hepatitis A admitted at two university-affiliated hospitals were reviewed. Patients were classified into three groups: group A, patients with both acute hepatitis A and underlying chronic hepatitis B (n = 27); group B, patients infected by acute hepatitis A alone whose sexes and ages were matched with patients in group A (n  = 54); and group C, patients with acute hepatitis A alone (n = 731). None of the demographic features of group A were significantly different from those of group B or C, except for the proportion of males and body weight, which differed from group C. When comparing to group B, clinical symptoms were more frequent, and higher total bilirubin and lower albumin levels were observed in group A. When comparing to group C, the albumin levels were lower in group A. There were no differences in the duration of hospital stay, occurrence of acute kidney injury, acute liver failure, prolonged cholestasis, or relapsing hepatitis. This study revealed that clinical symptoms and laboratory findings were less favorable for patients with acute hepatitis A and chronic hepatitis B compared to those with acute hepatitis A alone. However, there were no differences in fatal outcomes or serious complications.
Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.
Su Rin
SR
Shin
In Ho
IH
Moh
Sung Won
SW
Jung
Jin Bae
JB
Kim
Sang Hoon
SH
Park
Hyoung Su
HS
Kim
Myung Kuk
MK
Jang
Myung Seok
MS
Lee
D058186:Acute Kidney Injury / Q000453:epidemiology; D000328:Adult; D001663:Bilirubin / Q000097:blood; D002779:Cholestasis / Q000453:epidemiology; D005260:Female; D006506:Hepatitis A / Q000473:pathology*; D019694:Hepatitis B, Chronic / Q000150:complications*; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D017114:Liver Failure, Acute / Q000453:epidemiology; D008297:Male; D012008:Recurrence; D012709:Serum Albumin / Q000032:analysis; D016896:Treatment Outcome
D012709:Serum Albumin; D001663:Bilirubin