Article    Table of Contents                    Full Text of this article Free    Figures/Tables List  Services    Send comment/rapid response letter    Notify a friend about this article    Alert me when this article is cited    Add to Personal Archive    Download to Citation Manager    ACP Search                            Get Permissions  Google Scholar    Search for Related Content  PubMed Articles in PubMed by Author:    Willner, I. R.    Waters, B.    Related Articles in PubMed    PubMed Citation    PubMed

BRIEF COMMUNICATION

Serious Hepatitis A: An Analysis of Patients Hospitalized during an Urban Epidemic in the United States

Ira R. Willner, MD; Mark D. Uhl, MD; Scott C. Howard, MD; Ernest Q. Williams, MD; Caroline A. Riely, MD; and Bradford Waters, MD

15 January 1998 | Volume 128 Issue 2 | Pages 111-114

Background: Memphis and Shelby County, Tennessee, experienced an epidemic of hepatitis A in 1994 and 1995. More than 1700 cases were reported.

Objective: To characterize the clinical features of patients hospitalized during a large urban epidemic of hepatitis A.

Design: Retrospective chart review.

Setting: 15 acute care hospitals in Shelby County, Tennessee.

Patients: 256 patients hospitalized with acute hepatitis A.

Measurements: Laboratory findings (such as prothrombin time and bilirubin level), complications, and mortality.

Results: The median patient age was 26 years. Thirty-nine complications occurred in 35 patients. Twenty patients (8%) had extrahepatic complications, and 5 (2%) died. Patients 40 years of age and older were more likely to have serious complications, including death (P = 0.014). Sixty-seven patients (26%) presented with coagulopathy (prothrombin time 3 seconds prolonged). Fifty-four patients (21%) had a bilirubin level greater than 170 µmol/L (10 mg/dL).

Conclusions: During this epidemic, hepatitis A caused serious illness and death. Complications were more frequent in patients 40 years of age and older, but young, healthy persons were also at risk for severe complications.

Author and Article Information

From the University of Tennessee, Memphis, Tennessee.
Requests for Reprints: Ira R. Willner, MD, Liver Service, Gastroenterology Division, Medical University of South Carolina, 916 Clinical Science Building, 171 Ashley Avenue, Charleston, SC 29425.
Current Author Addresses: Dr. Willner: Liver Service, Gastroenterology Division, Medical University of South Carolina, 916 Clinical Science Building, 171 Ashley Avenue, Charleston, SC 29425.

This article has been cited by other articles:

				A. LETAIEF, N. KAABIA, R. GAHA, A. BOUSAADIA, F. LAZRAG, H. TRABELSI, H. GHANNEM, and L. JEMNI AGE-SPECIFIC SEROPREVALENCE OF HEPATITIS A AMONG SCHOOL CHILDREN IN CENTRAL TUNISIA Am J Trop Med Hyg, July 1, 2005; 73(1): 40 - 43. [Abstract] [Full Text] [PDF]

				A. S. Craig and W. Schaffner Prevention of Hepatitis A with the Hepatitis A Vaccine N. Engl. J. Med., January 29, 2004; 350(5): 476 - 481. [Full Text] [PDF]

				M G Brook Sexually acquired hepatitis Sex. Transm. Inf., August 1, 2002; 78(4): 235 - 240. [Abstract] [Full Text] [PDF]

				K Fujiwara, O Yokosuka, T Ehata, H Saisho, N Saotome, K Suzuki, K Okita, K Kiyosawa, and M Omata Association between severity of type A hepatitis and nucleotide variations in the 5` non-translated region of hepatitis A virus RNA: strains from fulminant hepatitis have fewer nucleotide substitutions Gut, July 1, 2002; 51(1): 82 - 88. [Abstract] [Full Text] [PDF]

				J. A. Cuthbert Hepatitis A: Old and New Clin. Microbiol. Rev., January 1, 2001; 14(1): 38 - 58. [Abstract] [Full Text] [PDF]

				D. R. Dufour, J. A. Lott, F. S. Nolte, D. R. Gretch, R. S. Koff, and L. B. Seeff Diagnosis and Monitoring of Hepatic Injury. I. Performance Characteristics of Laboratory Tests Clin. Chem., December 1, 2000; 46(12): 2027 - 2049. [Abstract] [Full Text] [PDF]

				T. Asselah, J. Bernuau, and P. Marcellin Prevalence of Hepatitis C Virus Infection in Patients Hospitalized for Hepatitis A Ann Intern Med, March 2, 1999; 130(5): 451 - 451. [Full Text] [PDF]

				R. S. Koff The Case for Routine Childhood Vaccination against Hepatitis A N. Engl. J. Med., February 25, 1999; 340(8): 644 - 645. [Full Text]

				The Ugly Side of Hepatitis A Journal Watch Infectious Diseases, March 1, 1998; 1998(301): 11 - 11. [Full Text]

				M. E. Wise and F. Sorvillo Hepatitis A-Related Mortality in California, 1989-2000: Analysis of Multiple Cause-Coded Death Data Am J Public Health, May 1, 2005; 95(5): 900 - 905. [Abstract] [Full Text] [PDF]