In the United States between 2005 and 2014, inpatient prevalence of hepatitis A virus (HAV) in kidney transplant recipients was 23.42 cases per 100,000 admissions, and hospitalization for HAV after kidney transplantation was associated with increased intensive care unit (ICU) stay, coexisting hepatitis B and C infection, and liver failure, according to results of a study published in the European Journal of Gastroenterology & Hepatology.1

Hospitalization rates for HAV infection among the general population in the United States decreased between 2002 and 2011,2 however data on epidemiology of HAV infection in kidney transplant recipients are lacking. Moreover, previous studies have shown a poor response to HAV vaccination among recipients of kidney transplantation.3,4

Therefore, researchers conducted a study using a large US inpatient database between 2005 and 2014 to evaluate the hospitalization rate for HAV among kidney transplant recipients and its outcomes as well as resource utilization, when compared with kidney transplant recipients without HAV.1

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Of 871,024 kidney transplant recipients identified, 204 had HAV; therefore, the overall inpatient prevalence of HAV in this patient population was 23.42 cases per 100,000 admissions. Researchers found that there were no statistically significant changes in the inpatient prevalence of HAV in kidney transplant recipients during the study period (P = .77).

Among hospitalized kidney transplant recipients with HAV, 27.9% were from the Northeast, 29.2% were from the Midwest, 23.8% were from the South, and 19.1% were from the West. HAV was not significantly associated with increased hospital mortality, multiorgan failure, need for abdominal ultrasound, hospital length of stay, and total hospitalization costs and charges when compared with those without HAV. However, it was significantly associated with an increased ICU stay, coexisting hepatitis B and C infection, and liver failure.

The study authors concluded that, “Our study is the first to demonstrate the hospitalization rate/trend for HAV among [kidney transplant] recipients between years 2005 and 2014.”1

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  1. Cheungpasitporn W, Thongprayoon C, Ungprasert P, et al. Hepatitis A hospitalizations among kidney transplant recipients in the United States: nationwide inpatient sample 2005–2014. Eur J Gastroenterol Hepatol. 2020:32(5);650-655.
  2. Collier MG, Tong X, Xu F. Hepatitis A hospitalizations in the United States, 2002-2011. Hepatology. 2015;61(2):481-485.
  3. Jeon HJ, Ro H, Jeong JC, et al. Efficacy and safety of hepatitis A vaccination in kidney transplant recipients. Transpl Infect Dis. 2014;16(3):511-515.
  4. Stark K, Günther M, Neuhaus R, et al. Immunogenicity and safety of hepatitis A vaccine in liver and renal transplant recipients. J Infect Dis. 1999;180(6):2014-2017.