Characteristics of acute hepatitis A virus infection before and after 2001: A hospital‐based study in Tokyo, Japan. Issue 10 (10th April 2019)

• Record Type: Journal Article
• Authors: Kogiso, Tomomi; Sagawa, Takaomi; Oda, Mayuko; Yoshiko, Somura; Kodama, Kazuhisa; Taniai, Makiko; Tokushige, Katsutoshi
• Is Part Of: Journal of gastroenterology and hepatology. Volume 34:Issue 10(2019)
• Page Start: 1836
• Page End: 1842
• Publication Date: 2019-04-10
• Subjects: acute hepatitis A [AH (A)] -- coinfection -- sexual transmission; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.14655
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Background and Aim: The incidence of acute hepatitis A [AH (A)] is decreasing because of improvements in hygiene; however, cases of sporadic severe hepatitis are still being reported. We assessed the epidemiology of AH (A) in Japan. Methods: This was a hospital‐based retrospective study, in which 126 AH (A) patients (96 men [76%], median age 39 [range, 19–66] years) were enrolled. Patients diagnosed with AH (A) before 2001 ( n = 79) and after 2001 ( n = 47) were compared. Results: The incidence of AH (A) showed peaks in 1990, 1999, and 2018. After 2001, one patient had hepatitis B virus, four had human immunodeficiency virus, and three had syphilis coinfections. Before and after 2001, HAV was transmitted, respectively, by raw oysters (28% and 26%), overseas travel (19% and 28%), and sexual contact (0% and 19%) ( P < 0.01). The frequencies of symptoms were appetite loss (51% and 32%), fever (63% and 81%), and diarrhea (3% and 13%) (all P < 0.05), respectively. On admission, the median levels of alanine aminotransferase (1455 and 3069 U/L) and γ‐glutamyl transpeptidase (221 and 345 U/L) were significantly higher ( P < 0.01), and the prothrombin time (77.5% and 65.9%) and platelet count (22.7 and 16.4 × 10/μL) were significantly lower after 2001 ( P < 0.05). A time to normalization of the bilirubin level ≥ 30 days was associated with older age and a diagnosis of AH (A) after 2001. Conclusions: Outbreaks and severe AH (A) cases due to sexual transmission have been reported recently. It is necessary to examine their sexual behavior and other sexual infection.