Gender Impacts on the Disease Severity of Overt Acute Hepatitis A: Different from Overt Acute Hepatitis B
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Acute hepatitis A (AH-A) and acute hepatitis B (AH-B) were found more severe in males and females, respectively, while impacts from underlying liver disease on severity were not excluded in the AH-A study.
The precise gender-specific impact on the severity of AH-A was investigated and compared with that of AH-B.
A case–control study of overt AH-A (n = 118) and AH-B (n = 118) patients without any underlying liver disease was conducted. Overt hepatitis was defined as serum bilirubin ≥ 2 mg/dL and alanine transaminase (ALT) ≥ 10 × upper limit of normal.
Of the AH-A patients, age (95% confidence interval of odds ratio 1.051–1.147) and ALT (1.001–1.002) were associated with hepatic decompensation. Indifferent rates of hepatic decompensation, hepatic failure, and mortality were found between male and female patients. Compared with the AH-B patients, AH-A patients showed lower bilirubin levels (p < 0.001), hepatic decompensation (p = 0.004), and mortality rates (p = 0.013). Among patients < 40 years, the AH-A patients had higher hepatic decompensation rates than AH-B in the male subgroup (15% vs. 2.8%, p = 0.045), while the situation is reverse in the female subgroup (7.7% vs. 48.1%, p = 0.001).
Overt AH-A was less severe than overt AH-B and, unlike AH-B, had no difference in severity between males and females. Among subgroups < 40 years, AH-A was more severe than AH-B in males, but the situation was reverse in females in terms of hepatic decompensation rates.
KeywordsHepatic decompensation Hepatic failure Gender dimorphism Acute hepatitis A
The authors thank Ms Shu-Chun Chen for her data mining assistance and Ms. Su-Chiung Chu for assistance in preparing the article. Part data of the patients with AH-B had been published in Hepatology, 2017;66:995–996. This study was supported by grants from the Chang Gung Medical Research Program (CMRPG1G0061, CMRPG1G0062) and the National Science Council, Taiwan (106-2314-B-182-041-MY2).
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Conflict of interest
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