Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2015, vol. 24, nr 5, September-October, p. 829–836

doi: 10.17219/acem/27566

Publication type: original article

Language: English

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

Maciej Bura1,2,A,B,C,D,E,F, Michał Michalak3,C,D,E, Michał K. Chojnicki2,B, Arleta Kowala-Piaskowska1,2,E, Iwona Mozer-Lisewska1,2,A,C,D,E,F

1 Department of Infectious Diseases, University of Medical Sciences, Poznań, Poland

2 Department of Infectious Diseases, Jozef Strus Multidisciplinary Municipal Hospital, Poznań, Poland

3 Department of Computer Science and Statistics, University of Medical Sciences, Poznań, Poland

Abstract

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.
Conclusion. 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.

Key words

hepatitis A, HAV, acute hepatits, acalculous cholecystitis

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