{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T07:20:36Z","timestamp":1767165636509,"version":"build-2238731810"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,4,10]],"date-time":"2019-04-10T00:00:00Z","timestamp":1554854400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>The incidence of acute hepatitis A [AH (A)] is decreasing because of improvements in hygiene; however, cases of sporadic severe hepatitis are still being reported. We assessed the epidemiology of AH (A) in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a hospital\u2010based retrospective study, in which 126 AH (A) patients (96 men [76%], median age 39 [range, 19\u201366] years) were enrolled. Patients diagnosed with AH (A) before 2001 (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a079) and after 2001 (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a047) were compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The incidence of AH (A) showed peaks in 1990, 1999, and 2018. After 2001, one patient had hepatitis B virus, four had human immunodeficiency virus, and three had syphilis coinfections. Before and after 2001, HAV was transmitted, respectively, by raw oysters (28% and 26%), overseas travel (19% and 28%), and sexual contact (0% and 19%) (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.01). The frequencies of symptoms were appetite loss (51% and 32%), fever (63% and 81%), and diarrhea (3% and 13%) (all\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), respectively. On admission, the median levels of alanine aminotransferase (1455 and 3069\u00a0U\/L) and \u03b3\u2010glutamyl transpeptidase (221 and 345\u00a0U\/L) were significantly higher (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.01), and the prothrombin time (77.5% and 65.9%) and platelet count (22.7 and 16.4\u00a0\u00d7\u00a010\/\u03bcL) were significantly lower after 2001 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). A time to normalization of the bilirubin level \u2265\u00a030\u00a0days was associated with older age and a diagnosis of AH (A) after 2001.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Outbreaks and severe AH (A) cases due to sexual transmission have been reported recently. It is necessary to examine their sexual behavior and other sexual infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.14655","type":"journal-article","created":{"date-parts":[[2019,3,12]],"date-time":"2019-03-12T16:43:51Z","timestamp":1552409031000},"page":"1836-1842","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Characteristics of acute hepatitis A virus infection before and after 2001: A hospital\u2010based study in Tokyo, Japan"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1248-4324","authenticated-orcid":false,"given":"Tomomi","family":"Kogiso","sequence":"first","affiliation":[{"name":"Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takaomi","family":"Sagawa","sequence":"additional","affiliation":[{"name":"Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayuko","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Microbiology Tokyo Metropolitan Institute of Public Health  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Somura","family":"Yoshiko","sequence":"additional","affiliation":[{"name":"Department of Microbiology Tokyo Metropolitan Institute of Public Health  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhisa","family":"Kodama","sequence":"additional","affiliation":[{"name":"Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makiko","family":"Taniai","sequence":"additional","affiliation":[{"name":"Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsutoshi","family":"Tokushige","sequence":"additional","affiliation":[{"name":"Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,10]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.82.9.2627"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.80.19.5885"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0264-410X(92)90559-3"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198510243131706"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/141.2.151"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1970.03170190035005"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0264-410X(99)00470-3"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1981.03310330017016"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/164.5.852"},{"key":"e_1_2_5_11_1","first-page":"1","article-title":"Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"55","author":"Fiore AE","year":"2006","journal-title":"MMWR Recomm. 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