Acute hepatitis A and acquired immunity to hepatitis A virus in hepatitis B virus (HBV) carriers and in HBV‐ or hepatitis C virus‐related chronic liver diseases in Thailand

Pramoolsinsap, Chutima

doi:10.1046/j.1365-2893.2000.00017.x

Cited by 32 publications

(30 citation statements)

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“…It has been reported that when hepatitis A is superimposed on chronic hepatitis C, it frequently shows critical clinical course and accompany high rate of fulminant hepatitis and mortality 10. However, the affect of hepatitis B virus (HBV) infection on the severity of viral hepatitis A differs among researches 10,14-17…”

Section: Introductionmentioning

confidence: 99%

Factors influencing the severity of acute viral hepatitis A

Kim

Jung

et al. 2010

Korean J Hepatol

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Background/AimsMost patients with acute viral hepatitis A have a favorable course, but a few of them suffer from severe forms of hepatitis such as fulminant hepatitis. This study was carried out to identify the factors influencing the severity of acute viral hepatitis A.MethodsWe retrospectively reviewed the medical records of 713 patients with acute hepatitis A, who were divided into two groups: severe hepatitis A (N=87) and non-severe hepatitis A (N=626). Severe hepatitis was defined as fulminant hepatitis or prolongation of prothrombin time (INR≥1.5). Clinical variables were compared between the two groups.ResultsThe incidence of fulminant hepatitis was 1.4% (10/713) in patients with acute hepatitis A. Thirty-three (4.6%) cases exhibited HBsAg positivity. In multivariate analyses, significant alcohol intake and the presence of HBsAg were significant predictive factors of fulminant hepatitis A, and significant alcohol intake and age were significant predictive factors of severe hepatitis A. HBeAg and HBV-DNA status did not affect the clinical course of hepatitis A in chronic hepatitis B carriers.ConclusionsWhile most patients with acute hepatitis A have an uncomplicated clinical course, our data suggest that a more-severe clinical course is correlated with being older, significant alcohol intake, and chronic hepatitis-B-virus infection.

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Section: Introductionmentioning

confidence: 99%

Factors influencing the severity of acute viral hepatitis A

Kim

Jung

et al. 2010

Korean J Hepatol

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“…The possibility of a severe clinical course has, however, been suggested by some reports from Asia. For example, in a study from Thailand, 29% of patients with HAV superinfection died, and all of them were older than 50 (2 of the 3 superinfected patients in the present study were in this age group) [22,23]. Authors from South Korea found a 22-fold increase in the risk of fulminant hepatitis in hepatitis A superimposed on HBsAg carriage; in their analysis, this clinical scenario was observed in 12% of the cases [24].…”

Section: Discussionmentioning

confidence: 42%

Viral Hepatitis A in 108 Adult Patients During an Eight-Year Observation in a Single Center in Poland

Bura¹,

Michalak²,

Chojnicki³

et al. 2015

Adv Clin Exp Med

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Background. Hepatitis A is related to significant morbidity and occasional mortality. Based on data from the Polish National Institute of Hygiene, from 2000 to 2013 a mean of 213 hepatitis A cases were reported yearly. Objectives. The aim of the study was to assess selected data in adults hospitalized for symptomatic hepatitis A during an eight-year period in a single center in the Wielkopolska Region of Poland. Material and Methods. All the hepatitis A patients hospitalized in the center from 2005 to 2013 were analyzed retrospectively. Data were extracted from the medical records of these individuals. The disease was confirmed by anti-HAV IgM testing. Results. In total, 108 patients (71 men and 37 women), aged 18-65 years, were identified. All but 1 patient recovered (99.1%) and in 6 cases (5.6%) a relapse occurred. Risk factors for hepatitis A were identified in 56 patients (52%), with travel abroad being the most common one (32 patients); 19 cases were secondary and 5 patients were men who have sex with men. One hepatitis A outbreak was noted in the region during the study period. Acalculous cholecystitis was found in 33.3% of the patients who underwent abdominal ultrasound. This tended to be more common among older individuals (47.8% in patients over 40 vs. 22.6% in patients aged 18-40, p = 0.0521). Patients with this finding had significantly higher mean peak ALT in comparison to those with no gallbladder abnormalities. Conclusions. Although hepatitis A in adults is typically a benign, self-limited disease, it can occasionally have a fatal course. In a significant proportion of patients with an evident risk factor for hepatitis A, the possibility of active prophylaxis was not used. Hepatitis A should be regarded as a sexually transmitted infection. Acalculous cholecystitis is a frequent finding among adults with symptomatic hepatitis A (Adv Clin Exp Med 2015, 24, 5, 829-836).

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“…In recent years, two studies have investigated the influence of acute HAV superinfection in Taiwan and Thailand, areas with endemic HAV and HBV infection. Chu and Liaw15 reported that HBsAg carriers were at a nine-fold increased risk of fulminant hepatitis compared with non-carriers, and Pramoolsinsap17 reported that fulminant or submassive hepatitis occurred in 10 of 20 (55%) HBsAg carriers and in 4 of 12 (33%) patients with HBV- or HCVrelated chronic liver disease.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Clinical Features of Hepatitis A between HBsAg-Positive and HBsAg-Negative Patients

Kim¹,

Eo²,

Gwak³

et al. 2011

Gut Liver

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Background/AimsThe notion that acute hepatitis A superimposed on chronic hepatitis B infection leads to a worse outcome than acute hepatitis A alone remains controversial. The aim of this study was to determine the influence of the presence of hepatitis B surface antigen (HBsAg) on the severity of acute hepatitis A.MethodsWe retrospectively analyzed 449 patients hospitalized for acute hepatitis A from January 2000 to February 2010 and compared clinical outcomes based on the presence of HBsAg.ResultsOf the 449 patients, 30 patients were in the HBsAg-positive group and 419 in the HBsAg-negative group. The HBsAg-positive group was older than the HBsAg-negative group (36.1±8.3 vs 31.8±8.5 years, p=0.004); however, other baseline characteristics were similar between the 2 groups. Mean peak values of prothrombin time, serum total bilirubin, and serum creatinine at admission were significantly higher in the HBsAg-positive group. When comparing clinical outcomes between the 2 groups, gastrointestinal bleeding, acute renal failure, and acute liver failure were more frequently observed in the HBsAg-positive group. In particular, the incidence of acute liver failure was approximately 9-fold higher in the HBsAg-positive group than in the HBsAg-negative group (23.3% vs 3.3%; odds ratio [OR], 8.80; p<0.001). Multivariate analysis showed that HBsAg (OR, 7.43; 95% confidence interval [CI], 2.56 to 21.57) and age (OR, 1.07; 95% CI, 1.02 to 1.13) were independent risk factors for the occurrence of acute liver failure.ConclusionsIn patients with chronic hepatitis B infection, acute hepatitis A is associated with more severe clinical outcomes, including acute liver failure, compared with patients with acute hepatitis A alone.

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Acute hepatitis A and acquired immunity to hepatitis A virus in hepatitis B virus (HBV) carriers and in HBV‐ or hepatitis C virus‐related chronic liver diseases in Thailand

Cited by 32 publications

References 3 publications

Factors influencing the severity of acute viral hepatitis A

Factors influencing the severity of acute viral hepatitis A

Viral Hepatitis A in 108 Adult Patients During an Eight-Year Observation in a Single Center in Poland

Comparison of the Clinical Features of Hepatitis A between HBsAg-Positive and HBsAg-Negative Patients

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