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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
- 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.
Abstract
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.
- Copyright ©2004 by the American College of Physicians
