Clinical Features and Risk Factors for Severe Complications among Patients with Acute Hepatitis A Virus Infection in The Jeonbuk Province of Korea

• Published in: The Korean journal of gastroenterology Vol. 63; no. 1; pp. 25 - 31
• Main Authors: Yoo, Sun Ho, Kim, In Hee, Jang, Ji Won, Choi, Chung Hwan, Moon, Jin Chang, Park, Jin Kyoung, Lee, Sang Youn, Kim, Seong Hun, Kim, Sang Wook, Lee, Seung Ok, Lee, Soo Teik, Kim, Dae Ghon, Cho, Eun Young, Jung, Gum Mo
• Format: Journal Article
• Language: English
• Published: 대한소화기학회 2014
• Subjects: 내과학
• ISSN: 1598-9992; 2233-6869
• DOI: 10.4166/kjg.2014.63.1.25

Background/Aims: 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. KCI Citation Count: 2