{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T18:20:37Z","timestamp":1790533237934,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,5,29]],"date-time":"2019-05-29T00:00:00Z","timestamp":1559088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["18fk0210043h0001"],"award-info":[{"award-number":["18fk0210043h0001"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>A nationwide survey of acute liver failure (ALF) and late\u2010onset hepatic failure (LOHF) has revealed that the outcomes of recent patients whose diseases were caused by infection with hepatitis A virus (HAV) have worsened, compared with those of previously reported patients. The factors associated with this deterioration were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 83 patients with HAV infection seen between 1998 and 2015 were enrolled. All the patients had a prothrombin time\u2013international normalized ratio of 1.5 or more and hepatic encephalopathy of grade 2 or more severe. The demographic and clinical features of 45 patients seen prior to 2003 (cohort 1) and 38 patients seen during 2004 and thereafter (cohort 2) were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three and four patients in cohort 1 and cohort 2, respectively, received liver transplantations; the survival rates among the remaining patients were 56% for cohort 2 and 79% for cohort 1 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). The mean age (\u00b1standard deviation) of the patients was higher in cohort 2 than in cohort 1 (58\u2009\u00b1\u200911 vs. 48\u2009\u00b1\u200913\u00a0years; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). The percentages of patients with underlying metabolic diseases were 22% in cohort 1 and 61% in cohort 2 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). Diabetic mellitus was more common among deceased patients than among rescued patients (29% vs. 8%; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) among patients who did not receive liver transplantations, and a multivariate analysis revealed that patient age and disease type were significantly and independently associated with the outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The outcomes of recent patients with ALF or LOHF caused by HAV infection have recently worsened mainly because of an increase in underlying metabolic diseases as a consequence of aging.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.13345","type":"journal-article","created":{"date-parts":[[2019,4,8]],"date-time":"2019-04-08T03:48:11Z","timestamp":1554695291000},"page":"844-852","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Deteriorated outcome of recent patients with acute liver failure and late\u2010onset hepatic failure caused by infection with hepatitis A virus: A subanalysis of patients seen between 1998 and 2015 and enrolled in nationwide surveys in Japan"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2850-6973","authenticated-orcid":false,"given":"Masamitsu","family":"Nakao","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuaki","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6012-0915","authenticated-orcid":false,"given":"Yoshihito","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoaki","family":"Tomiya","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Oketani","sequence":"additional","affiliation":[{"name":"Digestive and Lifestyle Diseases, Department of Human and Environmental Sciences Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"},{"name":"Department of Medicine Yoshinohigashi Home Clinic  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Ido","sequence":"additional","affiliation":[{"name":"Digestive and Lifestyle Diseases, Department of Human and Environmental Sciences Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohito","family":"Tsubouchi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kagoshima City Hospital  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Takikawa","sequence":"additional","affiliation":[{"name":"Faculty of Medical Technology Teikyo University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Mochida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,29]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"The proceedings of the 12th Inuyama Symposium.Hepatitis Type A-Fulminant Hepatitis. 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