Serious hepatitis A: an analysis of patients hospitalized during an urban epidemic in the United States

Ann Intern Med. 1998 Jan 15;128(2):111-4. doi: 10.7326/0003-4819-128-2-199801150-00006.


Background: Memphis and Shelby County, Tennessee, experienced an epidemic of hepatitis A in 1994 and 1995. More than 1700 cases were reported.

Objective: To characterize the clinical features of patients hospitalized during a large urban epidemic of hepatitis A.

Design: Retrospective chart review.

Setting: 15 acute care hospitals in Shelby County, Tennessee.

Patients: 256 patients hospitalized with acute hepatitis A.

Measurements: Laboratory findings (such as prothrombin time and bilirubin level), complications, and mortality.

Results: The median patient age was 26 years. Thirty-nine complications occurred in 35 patients. Twenty patients (8%) had extrahepatic complications, and 5 (2%) died. Patients 40 years of age and older were more likely to have serious complications, including death (P = 0.014). Sixty-seven patients (26%) presented with coagulopathy (prothrombin time > or = 3 seconds prolonged). Fifty-four patients (21%) had a bilirubin level greater than 170 micromol/L (10 mg/dL).

Conclusions: During this epidemic, hepatitis A caused serious illness and death. Complications were more frequent in patients 40 years of age and older, but young, healthy persons were also at risk for severe complications.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Age Factors
  • Disease Outbreaks*
  • Female
  • Hepatitis A / complications
  • Hepatitis A / epidemiology*
  • Hepatitis A / mortality
  • Hospitalization
  • Humans
  • Male
  • Retrospective Studies
  • Risk Factors
  • Tennessee / epidemiology
  • Urban Health*