Clinical outcomes in patients with hepatitis A virus infection in a tertiary center: retrospective cohort 2022-2024.

Introduction and Objectives

In Mexico, the incidence rate of hepatitis A virus (HAV) infection is 3.11/100,000 person/year. 70% of adults develop symptoms, representing 3% of cases of acute liver failure (ALF). This study aimed to evaluate the clinical outcomes obtained in our institution.

Materials and Patients

It is a retrospective, observational cohort study, which included all patients over 18 years of age hospitalized from March 2022 to April 2024. 16 patients with a confirmed diagnosis of HAV infection (IGM) who required hospital management in the Centro Medico Nacional 20 de Noviembre ISSSTE were included. All patients who did not have a confirmatory serological test were excluded. The SPSS v.24 program was used for statistical analysis, using frequencies and percentages for reporting the data.

Results

Of the total of 16 cases included, 31.3% (5) patients were women, and 68.8% (11) were men, with an average age of 35 years old (19-47). The comorbidities they presented were: type 2 diabetes in 18.8% (3), systemic arterial hypertension in 6.3% (1), rheumatoid arthritis in 6.3% (1). Among the clinical manifestations they presented during the evolution were the following: hepatic encephalopathy 31.3% (5), abdominal pain 62.5% (10), fever 3.1% (8), vomiting 3.5% (9), diarrhea 1.6% (4). Of our studied population, 25.0% (4) patients developed acute liver failure requiring attention in the intensive care unit, where they received adjuvant treatment based on n-acetylcysteine ​​and renal replacement therapy. The remaining patients presented alarm symptoms 75.0% (12) without developing liver failure. The mortality reported in our population was 18.8% (3).

Conclusions

The observed mortality was 18.8% (3) of the total included, higher than that reported worldwide. In recent years, an epidemiological transition has been seen in patients with FHA. Among the factors that increased mortality were serious infections, hydroelectrolytic alterations, and limiting the transplant protocol.

Ethical statement: This study follows the ethical principles of clinical research; no intervention was performed on patients and the information is obtained from the clinical record.

Declaration of interests: None.

Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.