KMID : 0614620140630010025
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Korean Journal of Gastroenterology 2014 Volume.63 No. 1 p.25 ~ p.31
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Clinical Features and Risk Factors for Severe Complications among Patients with Acute Hepatitis A Virus Infection in The Jeonbuk Province of Korea
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Yoo Sun-Ho
Kim In-Hee Jang Ji-Won Choi Jung-Hwan Moon Jin-Chang Park Jin-Kyoung Lee Sang-Youn Kim Seong-Hun Kim Sang-Wook Lee Seung-Ok Lee Soo-Teik Kim Dae-Ghon Cho Eun-Young Jung Gum-Mo
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Abstract
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Background/Aims:The frequency of symptomatic acute HAV infections in adulthood are increasing in Korea. This study analyzes the clinical severity in patients with acute HAV infection and investigates risk factors associated with three severe complications: prolonged cholestasis, acute kidney injury, and acute liver failure.
Methods: We performed a retrospective analysis of 726 patients diagnosed from January 2006 to December 2010 at three tertiary hospitals in Jeonbuk Province, Republic of Korea with acute HAV infection.
Results:In the group of 726 patients, the mean age was 30.3 years, 426 (58.6%) were male, and 34 (4.7%) were HBsAg positive. Severe complications from acute HAV infection occurred as follows: prolonged cholestasis in 33 (4.6%), acute kidney injury in 17 (2.3%), and acute liver failure in 16 (2.2%). Through multivariate analysis, age ¡Ã40 years (OR 2.63, p=0.024) and peak PT (INR) ¡Ã1.5 (OR 5.81, p=0.035) were found to be significant risk factors for prolonged cholestasis. Age ¡Ã40 years (OR 5.24, p=0.002) and female gender (OR 3.11, p=0.036) were significant risk factors for acute kidney injury. Age ¡Ã40 years (OR 6.91, p=0.002), HBsAg positivity (OR 5.02, p=0.049), and peak total bilirubin (OR 1.11, p=0.001) were significant risk factors for acute liver failure.
Conclusion: Age ¡Ã40 years, female gender, HBsAg positivity, peak PT (INR) ¡Ã1.5, and peak total bilirubin were significant risk factors for severe complications in acute HAV infections. (Korean J Gastroenterol 2014;63:25-31)
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KEYWORD
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Hepatitis A, Cholestasis, Acute kidney injuries, Acute liver failure, Risk
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