A retrospective Thai nationwide study of the incidence of acute hepatitis A infection and the impact of chronic liver disease comorbidity on survival

Hepatitis A virus (HAV) infection is common in developing countries. An accurate incidence of HAV infection and the effect of HAV infection on patients with chronic liver disease (CLD) are not well defined in Thailand. We aimed to determine the incidence of HAV infection in Thailand and the impact of CLD comorbidity on clinical outcomes among hospitalized patients. This was a nationwide, retrospective observational study conducted using hospital admission data during 2008 to 2013 from Nationwide Hospital Admission Data, National Health Security Office. All patients with a primary diagnosis of HAV infection were included in this study. Data regarding baseline characteristics, comorbidities, hospital course and survival were collected. Overall, 1,481 patients from 347 hospitals across Thailand were included in the study. Fifty-four point eight percent of patients (n=812) were from northeastern Thailand. Seventy-four point six percent of patients (n=1,105) contracted the infection during the rainy season (June to November) which was significantly more often (p60 years, history of liver cirrhosis and history of chronic hepatitis B or C infection were significantly positively associated with 30-day mortality. CLD was associated with a greater risk of mortality among study subjects. People in the study population with CLD, and those aged > 60 years should consider hepatitis A vaccination to reduce mortality risk associated with HAV infection