CLINICAL PREDICTORS OF PROLONGED CHOLESTASIS IN ADOLESCENT HEPATITIS A: A CROSS-SECTIONAL STUDY

Abstract

Background: Even though overall results are positive, persistent cholestasis is a rare but clinically significant consequence of acute hepatitis A that contributes to extended morbidity.

Objective: To identify clinical and laboratory predictors of prolonged cholestasis among adolescents hospitalized with acute hepatitis A.

Methods: this Cross sectional study conducted at Department Of Medicine, MTI-Hmc, Peshawar from Jan 2023 to june 2023.involving teenagers with serologically confirmed acute hepatitis A between the ages of 10 and 19 was carried out at Hayatabad Medical Complex in Peshawar. Conjugated hyperbilirubinemia (total bilirubin >5 mg/dL) that lasted longer than four weeks was considered prolonged cholestasis. Biochemical parameters and clinical characteristics were examined. Independent predictors were found using logistic regression.

Results: 18 (12%) of the 150 teenagers experienced persistent cholestasis. Female sex (aOR 3.1; 95% CI 1.1–8.7; p=0.03), peak total bilirubin >15 mg/dL (aOR 4.8; 95% CI 1.7–13.6; p=0.003), and severe pruritus (aOR 2.9; 95% CI 1.0–8.4; p=0.046) were independent predictors.

Conclusions: In teenagers with acute hepatitis A, prolonged cholestasis is strongly predicted by higher bilirubin levels, female gender, and severe pruritus. Supportive management and follow-up may be guided by early detection.