Clinical outcomes in patients with hepatitis A virus infection in a tertiary center: retrospective cohort 2022-2024.

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-04-01 DOI:10.1016/j.aohep.2025.101854

Norma N. Parra-Holguín, Yenni J. Cruz Ramírez, Reina S. Velez Ramírez, Francisco I. García-Juárez

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Abstract

Introduction and Objectives

In Mexico, the incidence rate of hepatitis A virus (HAV) infection is 3.11/100,000 person/year. 70% of adults develop symptoms, representing 3% of cases of acute liver failure (ALF). This study aimed to evaluate the clinical outcomes obtained in our institution.

Materials and Patients

It is a retrospective, observational cohort study, which included all patients over 18 years of age hospitalized from March 2022 to April 2024. 16 patients with a confirmed diagnosis of HAV infection (IGM) who required hospital management in the Centro Medico Nacional 20 de Noviembre ISSSTE were included. All patients who did not have a confirmatory serological test were excluded. The SPSS v.24 program was used for statistical analysis, using frequencies and percentages for reporting the data.

Results

Of the total of 16 cases included, 31.3% (5) patients were women, and 68.8% (11) were men, with an average age of 35 years old (19-47). The comorbidities they presented were: type 2 diabetes in 18.8% (3), systemic arterial hypertension in 6.3% (1), rheumatoid arthritis in 6.3% (1). Among the clinical manifestations they presented during the evolution were the following: hepatic encephalopathy 31.3% (5), abdominal pain 62.5% (10), fever 3.1% (8), vomiting 3.5% (9), diarrhea 1.6% (4). Of our studied population, 25.0% (4) patients developed acute liver failure requiring attention in the intensive care unit, where they received adjuvant treatment based on n-acetylcysteine and renal replacement therapy. The remaining patients presented alarm symptoms 75.0% (12) without developing liver failure. The mortality reported in our population was 18.8% (3).

Conclusions

The observed mortality was 18.8% (3) of the total included, higher than that reported worldwide. In recent years, an epidemiological transition has been seen in patients with FHA. Among the factors that increased mortality were serious infections, hydroelectrolytic alterations, and limiting the transplant protocol.

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三级中心甲型肝炎病毒感染患者的临床结局：回顾性队列2022-2024

在墨西哥，甲型肝炎病毒（HAV）感染的发病率为3.11/10万人/年。70%的成年人出现症状，占急性肝衰竭（ALF）病例的3%。本研究旨在评价在我院获得的临床结果。材料和患者这是一项回顾性、观察性队列研究，纳入了2022年3月至2024年4月期间住院的所有18岁以上患者。纳入了16例确诊为甲型肝炎感染（IGM）的患者，这些患者需要在国家医学中心（Centro Medico Nacional）进行住院治疗。所有未进行确认性血清学检查的患者均被排除在外。使用SPSS v.24程序进行统计分析，采用频率和百分比报告数据。结果16例患者中，女性占31.3%（5例），男性占68.8%（11例），平均年龄为35岁（19 ~ 47岁）。他们提出的合并症是：2型糖尿病18.8%(3)，全身性动脉高血压6.3%(1)，类风湿性关节炎6.3%(1)。临床表现为肝性脑病31.3%（5例），腹痛62.5%（10例），发热3.1%（8例），呕吐3.5%（9例），腹泻1.6%（4例）。在我们的研究人群中，25.0%(4)的患者出现急性肝衰竭，需要在重症监护室进行治疗，在那里他们接受了基于n-乙酰半胱氨酸和肾脏替代治疗的辅助治疗。其余患者出现报警症状75.0%（12例），未发生肝功能衰竭。我们人群中报告的死亡率为18.8%(3)。结论观察到的病死率为18.8%(3)，高于国际上报道的病死率。近年来，FHA患者出现了流行病学转变。增加死亡率的因素包括严重感染、电解质改变和限制移植方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.