Volume 34, Issue 10 pp. 1836-1842
Clinical Hepatology

Characteristics of acute hepatitis A virus infection before and after 2001: A hospital-based study in Tokyo, Japan

Tomomi Kogiso

Corresponding Author

Tomomi Kogiso

Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan

Correspondence

Tomomi Kogiso, Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.

Email: [email protected]

Search for more papers by this author
Takaomi Sagawa

Takaomi Sagawa

Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan

Search for more papers by this author
Mayuko Oda

Mayuko Oda

Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan

Search for more papers by this author
Somura Yoshiko

Somura Yoshiko

Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan

Search for more papers by this author
Kazuhisa Kodama

Kazuhisa Kodama

Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan

Search for more papers by this author
Makiko Taniai

Makiko Taniai

Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan

Search for more papers by this author
Katsutoshi Tokushige

Katsutoshi Tokushige

Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan

Search for more papers by this author
First published: 12 March 2019
Citations: 4
Declaration of conflict of interest: K. T. has received research funding from Sumitomo Dainippon Pharma Co. Ltd., Astellas Pharma Inc., Eisai Co. Ltd., Taiho Pharmaceutical Co. Ltd., Chugai Pharmaceutical Co. Ltd., Daiichi Sankyo Pharmaceutical Co. Ltd., AbbVie GK, Takeda Pharmaceutical Company Ltd., Asahi Kasei Co., Ajinomoto Co. Inc., and Otsuka Pharmaceutical Co. Ltd.

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.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.