Fulminant hepatitis A virus infection in the United States: Incidence, prognosis, and outcomes

Taylor, Ryan M.; Davern, Timothy J.; Muñoz, Santiago J.; Han, Stephen-Huy; McGuire, Brendan M.; Larson, Anne M.; Hynan, Linda S.; Lee, William M.; Fontana, Robert J.

doi:10.1002/hep.21439

Cited by 186 publications

(146 citation statements)

References 33 publications

(45 reference statements)

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“…Older age, encephalopathy and coagulopathy are all well identified poor prognosis parameters in this a clinical context [21]. The fatal case in the current study had all these variables.…”

Section: Discussionsupporting

confidence: 49%

Viral Hepatitis A in 108 Adult Patients During an Eight-Year Observation in a Single Center in Poland

Bura¹,

Michalak²,

Chojnicki³

et al. 2015

Adv Clin Exp Med

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Background. Hepatitis A is related to significant morbidity and occasional mortality. Based on data from the Polish National Institute of Hygiene, from 2000 to 2013 a mean of 213 hepatitis A cases were reported yearly. Objectives. The aim of the study was to assess selected data in adults hospitalized for symptomatic hepatitis A during an eight-year period in a single center in the Wielkopolska Region of Poland. Material and Methods. All the hepatitis A patients hospitalized in the center from 2005 to 2013 were analyzed retrospectively. Data were extracted from the medical records of these individuals. The disease was confirmed by anti-HAV IgM testing. Results. In total, 108 patients (71 men and 37 women), aged 18-65 years, were identified. All but 1 patient recovered (99.1%) and in 6 cases (5.6%) a relapse occurred. Risk factors for hepatitis A were identified in 56 patients (52%), with travel abroad being the most common one (32 patients); 19 cases were secondary and 5 patients were men who have sex with men. One hepatitis A outbreak was noted in the region during the study period. Acalculous cholecystitis was found in 33.3% of the patients who underwent abdominal ultrasound. This tended to be more common among older individuals (47.8% in patients over 40 vs. 22.6% in patients aged 18-40, p = 0.0521). Patients with this finding had significantly higher mean peak ALT in comparison to those with no gallbladder abnormalities. Conclusions. Although hepatitis A in adults is typically a benign, self-limited disease, it can occasionally have a fatal course. In a significant proportion of patients with an evident risk factor for hepatitis A, the possibility of active prophylaxis was not used. Hepatitis A should be regarded as a sexually transmitted infection. Acalculous cholecystitis is a frequent finding among adults with symptomatic hepatitis A (Adv Clin Exp Med 2015, 24, 5, 829-836).

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“…Older age, encephalopathy and coagulopathy are all well identified poor prognosis parameters in this a clinical context [21]. The fatal case in the current study had all these variables.…”

Section: Discussionsupporting

confidence: 49%

Viral Hepatitis A in 108 Adult Patients During an Eight-Year Observation in a Single Center in Poland

Bura¹,

Michalak²,

Chojnicki³

et al. 2015

Adv Clin Exp Med

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“…67 However, in a US multicenter study on patients with hepatitis A induced FHF, MELD was unable to predict outcome of patients on the LT list with a cstatistic of only 0.7. 68 However, there were only 4 deaths and therefore the significance of the study is unclear. The most common cause of mortality amongst FHF patients is cerebral edema and it is likely that other factors including intra cranial pressure are important in predicting waitlist mortality of FHF patients.…”

Section: Fulminant Hepatic Failurementioning

confidence: 94%

Model for End-stage Liver Disease

Singal

Kamath

2013

Journal of Clinical and Experimental Hepatology

133

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“…This number might be even lower in the past 6 yr, as recognized in a recent U.S. study. 8 Presumably, the growing availability of the hepatitis A and B vaccines will cause these viruses to continue to wane in significance.…”

Section: See Article On Page 1389mentioning

confidence: 99%