Less Severe but Prolonged Course of Acute Hepatitis A in Human Immunodeficiency Virus (HIV)-Infected Patients Compared With HIV-Uninfected Patients During an Outbreak: A Multicenter Observational Study

doi:10.1093/cid/ciy328

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Title:	Less Severe but Prolonged Course of Acute Hepatitis A in Human Immunodeficiency Virus (HIV)-Infected Patients Compared With HIV-Uninfected Patients During an Outbreak: A Multicenter Observational Study
Authors:	Lee, Yu-Lin Chen, Guan-Jhou Chen, Nan-Yu Liou, Bo-Huang Wang, Ning-Chi Lee, Yuan-Ti Yang, Chia-Jui Huang, Yu-Shan Tang, Hung-Jen Huang, Shie-Shian Lin, Yi-Chun Cheng, Chien-Yu Lee, Chen-Hsiang Chen, Tun-Chieh Wu, Ting-Shu Litt, Chun-Eng Lu, Po-Liang Hung, Chien-Ching
Contributors:	Changhua Christian Hosp, Dept Internal Med Natl Taiwan Univ Hosp, Dept Internal Med Natl Taiwan Univ, Coll Med Chang Gung Univ, Coll Med, Chang Gung Mem Hosp, Dept Internal Med Hsinchu MacKay Mem Hosp, Dept Internal Med Natl Def Med Ctr, Triserv Gen Hosp, Dept Internal Med Chung Shan Med Univ, Sch Med Chung Shan Med Univ Hosp, Dept Internal Med Far Eastern Mem Hosp, Dept Internal Med Natl Yang Ming Univ, Sch Med Natl Taiwan Univ Hosp, Hsin Chu Branch, Dept Internal Med Chi Mei Med Ctr, Dept Internal Med Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr Keelung Chang Gung Mem Hosp, Dept Internal Med Minist Hlth & Welf, Taoyuan Gen Hosp, Dept Internal Med Natl Yang Ming Univ, Sch Publ Hlth
Keywords:	viral hepatitis men who have sex with men fecal-oral transmission sexually transmitted disease coagulopathy
Date:	2018-11-15
Issue Date:	2019-11-15 15:47:15 (UTC+8)
Publisher:	OXFORD UNIV PRESS INC
Abstract:	Background. This multicenter retrospective cohort study aimed to compare the clinical presentations and evolution of acute hepatitis A (AHA) between human immunodeficiency virus (HIV)-infected patients and HIV-uninfected counterparts during the AHA outbreak. Methods. Clinical and laboratory data were collected from the medical records of the patients with AHA at the 14 hospitals around Taiwan between May 2015 and May 2017. Results. A total of 297 adult patients with AHA were included during the study period. Their mean age was 31.4 years (range, 19.0-76.1 years); 93.4% were men and 58.6% were men who have sex with men. Of 265 patients with known HIV serostatus, 166 (62.6%) were HIV infected. Compared with HIV-uninfected patients, HIV-infected patients had a lower peak alanine aminotransferase (ALT) level (median, 1312 vs 2014 IU/L, P = .003), less coagulopathy (6.0% vs 16.2%, P = .007), and less hepatomegaly or splenomegaly on imaging studies, but a higher rate of delayed resolution of hepatitis (38.8% vs 21.3%, P = .009). HIV-infected patients with plasma RNA load <1000 copies/ml, while receiving combination antiretroviral therapy (cART) had a higher peak ALT level (median, 1420 vs 978 IU/L P = .006) and less delay in resolution of hepatitis (30.6% vs 48.8%, P = .047) than patients without cART or with plasma RNA load >= 1000 copies/mL. Conclusions. During an AHA outbreak, HIV-infected patients had a lower severity, but delayed resolution, of AHA than HIV-uninfected patients. Better viral suppression by cART alleviated the impact of HIV infection on the disease course of AHA in HIV-infected patients.
???metadata.dc.relation.uri???:	http://dx.doi.org/10.1093/cid/ciy328
Relation:	Computers & Education, v.67, n.10, pp.1595-1602
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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