Disorders of Liver : Increased Incidence Of The Acute Hepatitis A In The Northeast Part Of The Seoul Province: Single Center (2nd Hospital) Data

Background/Aims: Recently, we observed the increased incidence of acute hepatitis A in adults. We aimed to assess whether an increasing incidence of acute hepatitis in our hospital (2nd) that responsible of primary care medicine in the northeast part of the Seoul. Methods: We retrospectively analyzed clinical course and causes in hospitalized patients with elevated liver enzymes from January 2002 to December 2006. We excluded patients initially diagnosed as liver cirrhosis or alcoholic liver disease or biliary tract infection or pancreatitis. (n=347) Results: 118 of 347 cases were diagnosed as acute viral hepatitis A, one hospitalized case in 2002, 12 in 2003, 4 in 2004, 22 in 2005 and 79 in 2006 respectively. Other causes of elevated liver enzyme included acute exacerbation of chronic viral hepatitis B (n=76), acute or chronic vital hepatitis C (n=5), biliary tract infection (n=25), toxic hepatitis (n=41), pancreatitis (n=12), EBV infection (n=4) and unknown causes (n=66). In initial laboratory data of acute viral hepatitis A patients, the mean AST, ALT, total bilirubin, ALP and r-GTP were 1,486 (±2,203) IU/L, 1,795 (±1,599) IU/L, 5.84 (±5.36) mg/dL, 164 (±114) IU/L and 262 (±148) IU/L respectively. 40 patients had shown prothrombin time prolongation (INR: 1.55±0.51). Of 2 patients were chronic viral hepatitis B with acute hepatitis A coinfection. Except 9 patients who were transfered to tertiary hospital for any reason, the other patients had favorable clinical course. Conclusions: Currently although acute viral hepatitis A was under-evaluated due to its favorable clinical course, the number of hospitalized patients was increased yearly. Therefore, we recommend a vaccination for decreasing acute viral hepatitis A and medical expenses.