Hepatitis A epidemic in the elderly

Background. The purpose of this study was to characterize acute hepatitis A in patients more than 40 years old. Methods. Retrospective chart reviews and physician questionnaires were used. Hospitalization, laborator\ tests, comorbid conditions, complications, and mortality were assessed. Results. A total of 180 cases of acute hepatitis A occurred in patients more than age 40. Hospitalization rates increased from 3% for the group aged 40 to 49 to 12% in the group aged 50 to 69 and 42% in those greater than or equal to70 years old. The mean peak total bilirubin value was higher in hospitalized patients than in nonhospitalized patients (12.4 mg/dL vs 7.7 mg/dL). Comorbid conditions included significant alcohol consumption (8%), diabetes (16.6%), cardiovascular disease (54%), and chronic obstructive pulmonary disease (COPD) (21%). Complications included pancreatitis (4.1%), ascites (8.3%), prolonged cholestatic features (7.6%), and death (0.8%). Conclusion. Hospitalization rates and rare complications associated with acute hepatitis A increase with age.