Clinical course and management of acute hepatitis A infection in adults
Journal Title: Annals of Hepatology - Year 2012, Vol 11, Issue 5
Abstract
Background. Hepatitis A is the most common type of viral hepatitis in Mexico. The change of hepatitis A epidemiology in Mexico from high to intermediate endemicity leads to increasing susceptible adults for severe illness. Objective. To describe the clinical characteristics and hospital outcome of adult patients with acute hepatitis A infection, and determine risk factor for mortality. Material and methods. This is a retrospective observational, multicentre study in Mexico City and in Guatemala City. All inhospital patients were followed until discharge or death. Risk factors for death/acute liver failure were identified. Results. Forty seven patients were analyzed, sixty percent were male, the prodrome phase was from 3 to 30 days. The three most common symptoms were fever, malaise and jaundice, with 87%, 74% and 62% respectively. The incidence of patients who were treated with antibiotics before hospital admission was up to 34%. Unnecessary imaging studies and out of guidelines drugs were used. Presence of encephalopathy, leukocytes > 19,000/mL, blood urea nitrogen > 36 mg/dL, creatinine > 2 mg/dL, albumin < 2.5 mg/dL and total bilirubin > 9.6 mg/dL, are predictors of mortality. Serum creatinine > 2 mg/dL has the best sensibility and specificity for predicting fulminant hepatitis/death. Conclusion. Acute hepatitis A infection in adults is associated some unnecessary diagnostic and therapeutic approach. Could be associated with fulminant hepatitis, and a creatinine value > 2 mg/dL is the best predictor for fulminant hepatitis and death.
Authors and Affiliations
Ileana MacKinney-Novelo, Josué Barahona-Garrido, Fátima Castillo-Albarran, Jean Santiago-Hernández, Nahum Méndez-Sánchez, Misael Uribe, Norberto Chávez-Tapia
Keywords
Related Articles
- EP ID EP78186
- DOI -
- Views 133
- Downloads 0
Platelet count/spleen diameter ratio for non-invasive prediction of high risk esophageal varices in cirrhotic patients
Background and objective. Prophylaxis therapy is indicated in cirrhotic patients with large esophageal varices or small varices with red wale signs (high risk esophageal varices; HREV). Endoscopic surveillance to detect...
Efficacy and safety of entecavir and/or tenofovir in hepatitis B compensated and decompensated cirrhotic patients in clinical practice
This study aimed to evaluate the efficacy and safety of entecavir and/or tenofovir in compensated (CC) or decompensated (DC) hepatitis B cirrhotic patients in real-life clinical practice. Of the 48 patients, included bet...
Alcoholic liver disease presents at advanced stage and progresses faster compared to non-alcoholic fatty liver diseas
Background and objective. Steatohepatitis is a common cause of liver disease due to alcohol (ALD) or non-alcoholic fatty liverdisease (NAFLD). We performed this study to compare natural history of ALD and NAFLD. Material...
Nutritional support in the treatment of chronic hepatic encephalopathy
The prevalence of under nutrition in cirrhotic patients is 61% and it usually progresses as the disease becomes more advanced. The deterioration in the nutritional status and its associated metabolic derangements has rai...
Acute kidney injury after liver transplantation is associated with viral hepatitis, prolonged warm ischemia, serum lactate and higher mortality