Document Detail


Atypical manifestations of hepatitis A infection: a prospective, multicenter study in Korea.
MedLine Citation:
PMID:  20572083     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The clinical outcome of symptomatic hepatitis A and the incidence and clinical characteristics of atypical presentation of hepatitis A were studied using prospective, multicenter design. The atypical presentation included delayed anti-hepatitis A virus (HAV) immunoglobulin M (IgM) seroconversion defined as positive anti-HAV IgM on the repeated test within 7 days of hospital admission after the initially negative result, prolonged cholestasis, and acute kidney injury (AKI). A total of 595 patients with symptomatic hepatitis A requiring hospital admission were enrolled prospectively from September 2006 to August 2008 in four major hospitals in a Korean city with a population of approximately 1 million. Clinical outcomes of symptomatic hepatitis A showed a case fatality rate of 0.2%, and fulminant hepatitis in 0.5%. Delayed anti-HAV IgM seroconversion was found in 6.4%, and was significantly associated with shorter intervals from symptom onset to hospital admission, higher body mass index, and lower alanine aminotransferase (ALT) level at admission. Prolonged cholestasis was found in 4.7% of patients, and could be predicted by preexisting chronic hepatitis B viral infection, prolonged prothrombin time, and higher total bilirubin level. AKI was complicated in 1.5%, which could be predicted by lower albumin level, higher ALT level, and higher white blood cell (WBC) count. More than half of the patients required hemodialysis. Substantial occurrence of delayed anti-HAV IgM seroconversion, prolonged cholestasis, and AKI was confirmed with various predictable factors, which could be helpful for accurate diagnosis and management of hepatitis A patients.
Authors:
Youn Mu Jung; Sang Jong Park; Jeong Sim Kim; Je-Hyuck Jang; Sang Hyub Lee; Jin-Wook Kim; Young Min Park; Seong Gyu Hwang; Kyu Sung Rim; Sook-Kyoung Kang; Hyun Seok Lee; Hae Sun Yun; Young Mee Jee; Sook-Hyang Jeong
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of medical virology     Volume:  82     ISSN:  1096-9071     ISO Abbreviation:  J. Med. Virol.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-06-29     Completed Date:  2010-09-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7705876     Medline TA:  J Med Virol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1318-26     Citation Subset:  IM    
Copyright Information:
(c) 2010 Wiley-Liss, Inc.
Affiliation:
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cholestasis / virology
Female
Hepatitis A / complications,  epidemiology*,  mortality,  pathology*
Hepatitis A Antibodies / blood*
Hepatitis A virus / immunology*
Hospitalization
Humans
Immunoglobulin M / blood*
Incidence
Kidney Diseases / therapy,  virology
Korea / epidemiology
Liver Function Tests
Male
Middle Aged
Mortality
Prospective Studies
Renal Dialysis
Time Factors
Chemical
Reg. No./Substance:
0/Hepatitis A Antibodies; 0/Immunoglobulin M

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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