コギソ　トモミ   Kogiso Tomomi   小木曽　智美    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Characteristics of acute hepatitis A virus infection before and after 2001: A hospital-based study in Tokyo, Japan.
掲載誌名	正式名：Journal of gastroenterology and hepatology 略　 称：J Gastroenterol Hepatol ISSNコード：14401746/08159319
巻・号・頁	34(10),pp.1836-1842
著者・共著者	Kogiso Tomomi†, Sagawa Takaomi, Oda Mayuko, Yoshiko Somura, Kodama Kazuhisa, Taniai Makiko, Tokushige Katsutoshi
担当区分	筆頭著者
発行年月	2019/10
概要	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.
DOI	10.1111/jgh.14655
PMID	30861194