Hepatitis A in Day-Care Centers

Hadler, Stephen C.; Webster, Hannah; Erben, J; Swanson, Judith E.; Maynard, James E.

doi:10.1056/nejm198005293022203

Cited by 265 publications

(36 citation statements)

References 16 publications

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“…This finding is consistent with previous reports that about 70% of infected children younger than 6 years of age are asymptomatic, whereas 70% of infected adults present with jaundice and other symptoms, which may be severe [3,19,20,21]. This finding suggests that AHA-associated ARF in addition to AHA is common in the adult population and that the severity of AHA is related to age.…”

Section: Discussionsupporting

confidence: 92%

Acute Hepatitis A-Associated Acute Renal Failure in Adults

Kim¹,

Yoon²,

Kim³

et al. 2008

Nephron Clin Pract

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Background/Aims: The development of acute renal failure (ARF) is a very rare complication in patients with acute hepatitis A (AHA). Methods: We retrospectively investigated the overall incidence, risk factors, and clinical outcomes of ARF associated with AHA. Diagnosis of AHA was made according to the typical hepatitis symptoms and positivity of immunoglobulin M anti-hepatitis A virus in 208 patients with AHA. Results: ARF was noted in 12 (5.7%) patients, and dialysis was required in 8 (66%) patients. The median duration of hospitalization for patients with ARF was 18 days (range, 6–50 days). The development of ARF was observed in older patients (p = 0.004) and in patients with diabetes (p = 0.001), excessive alcohol consumption (p = 0.01), prolonged international normalized ratio (p = 0.019), and elevated aspartate aminotransferase concentration (p = 0.034). Multivariate analysis revealed that old age (odds ratio, OR, 1.2), elevated aspartate aminotransferase concentration (OR, 1.05), and diabetes (OR, 18.5) were independent risk factors for ARF (each p < 0.001). The prognosis of patients with ARF was good, and renal function recovered completely. Conclusion: ARF associated with AHA is not rare, and the possibility of AHA should be considered in patients with ARF with hepatic dysfunction.

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Section: Discussionsupporting

confidence: 92%

Acute Hepatitis A-Associated Acute Renal Failure in Adults

Kim¹,

Yoon²,

Kim³

et al. 2008

Nephron Clin Pract

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“…In children, hepatitis A virus (HAV) infection is usually asymptomatic whereas symptomatic in adults, and also it rarely develop fulminant hepatitis or accompany serious complication such as acute renal failure 1,2. According to epidemiological research in Korea, anti-HAV positivity increases after birth and becomes 50% around age 10 and most adults had anti-HAV in early 1980s 3.…”

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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“…This may play an indirect role in viral transmission to other susceptibles. Neonatal nurseries, as well as child care centers caring for <2-3 year olds, are well recognized as high-risk areas for transmission of hepatitis A because these age groups are predominantly asymptomic with acute HAV infection (11,14,(21)(22)(23).…”

Section: Serologymentioning

confidence: 99%