Clinical features and risk factors for severe complications among patients with acute hepatitis A virus infection in the Jeonbuk Province of Korea.
OBJECTIVE
The frequency of symptomatic acute HAV infections in adulthood are increasing in Korea. This study analyzes the clinical severity in patients with acute HAV infection and investigates risk factors associated with three severe complications: prolonged cholestasis, acute kidney injury, and acute liver failure.


METHODS
We performed a retrospective analysis of 726 patients diagnosed from January 2006 to December 2010 at three tertiary hospitals in Jeonbuk Province, Republic of Korea with acute HAV infection.


RESULTS
In the group of 726 patients, the mean age was 30.3 years, 426 (58.6%) were male, and 34 (4.7%) were HBsAg positive. Severe complications from acute HAV infection occurred as follows: prolonged cholestasis in 33 (4.6%), acute kidney injury in 17 (2.3%), and acute liver failure in 16 (2.2%). Through multivariate analysis, age ≥40 years (OR 2.63, p=0.024) and peak PT (INR) ≥1.5 (OR 5.81, p=0.035) were found to be significant risk factors for prolonged cholestasis. Age ≥40 years (OR 5.24, p=0.002) and female gender (OR 3.11, p=0.036) were significant risk factors for acute kidney injury. Age ≥40 years (OR 6.91, p=0.002), HBsAg positivity (OR 5.02, p=0.049), and peak total bilirubin (OR 1.11, p=0.001) were significant risk factors for acute liver failure.


CONCLUSIONS
Age ≥40 years, female gender, HBsAg positivity, peak PT (INR) ≥1.5, and peak total bilirubin were significant risk factors for severe complications in acute HAV infections.
Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju 561-712, Korea.
Sun Ho
SH
Yoo
In Hee
IH
Kim
Ji Won
JW
Jang
Chung Hwan
CH
Choi
Jin Chang
JC
Moon
Jin Kyoung
JK
Park
Sang Youn
SY
Lee
Seong Hun
SH
Kim
Sang Wook
SW
Kim
Seung Ok
SO
Lee
Soo Teik
ST
Lee
Dae Ghon
DG
Kim
Eun Young
EY
Cho
Gum Mo
GM
Jung
D000208:Acute Disease; D058186:Acute Kidney Injury / Q000150:complications; D000328:Adult; D002779:Cholestasis / Q000150:complications; D005260:Female; D006506:Hepatitis A / Q000150:complications / Q000175:diagnosis*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D017114:Liver Failure, Acute / Q000150:complications; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers
D006514:Hepatitis B Surface Antigens