title: 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.
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: So Young
authors.identifier: 0000-0003-4290-1950
authors.initials: SY
authors.lastname: Kwon
authors.affiliation: Department of Internal Medicine, Hallym Univesity College of Medicine, Hallym Univesity Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Jong Eun
authors.initials: JE
authors.lastname: Yeon
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sook Hyang
authors.initials: SH
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine, Gachon University Graduate School of Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Oh Sang
authors.initials: OS
authors.lastname: Kwon
authors.affiliation: Department of Internal Medicine, Inha University School of Medicine, Inha University Hospital, Incheon, Korea.
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Hong Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Korea University Anam Hospital, Seoul, Korea.
authors.forename: Yeon Seok
authors.initials: YS
authors.lastname: Seo
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, Korea.
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Sohn
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Korea.
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yim
authors.affiliation: Department of Internal Medicine, The Catholic University of Korea School of Medicine, The Catholic University of Korea St. Mary's Hosptial, Seoul, Korea.
authors.forename: Jong Young
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Hallym Univesity College of Medicine, Hallym Univesity Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Myung Seok
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Kyungpook National University College of Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Young Oh
authors.initials: YO
authors.lastname: Kweon
authors.affiliation: Department of Internal Medicine, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea.
authors.forename: Jae Youn
authors.initials: JY
authors.lastname: Cheong
authors.affiliation: Department of Internal Medicine, Wonkwang University School of Medicine, Wonkwang University Hospital, Iksan, Korea.
authors.forename: Haak Cheoul
authors.initials: HC
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu, Korea.
authors.forename: Heon Ju
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Yonsei University Wonju Christian Hospital, Wonju, Korea.
authors.forename: Soon Koo
authors.initials: SK
authors.lastname: Baik
authors.affiliation: Department of Biostatistics, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hyonggin
authors.initials: H
authors.lastname: An
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Kwan Soo
authors.initials: KS
authors.lastname: Byun
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002779:Cholestasis / Q000453:epidemiology / Q000209:etiology; D003710:Demography; D006506:Hepatitis A / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology; D016031:Liver Transplantation; D008875:Middle Aged; D009017:Morbidity; D056910:Republic of Korea; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult
keywords: Hepatitis A; Morbidity; Mortality