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Indian Pediatrics

, Volume 56, Issue 9, pp 741–744 | Cite as

Hepatitis A Virus-related Pediatric Liver Disease Burden and its Significance in the Indian Subcontinent

  • Vikrant Sood
  • Bikrant Bihari Lal
  • Ekta Gupta
  • Rajeev Khanna
  • Manish K. Siloliya
  • Seema AlamEmail author
Research Paper
  • 2 Downloads

Abstract

Objectives

To study the Hepatitis A virus (HAV) infection-related pediatric liver disease burden.

Methods

Hospital records of 431 children (age <18 y) diagnosed to be suffering from acute HAV infection during 2011 to 2018 were extracted and analyzed. Additionally, a seroprevalence study was done on 2599 participants (696 children and 1903 adults).

Results

HAV infection accounted for about half (48.6% of acute hepatitis and 46.5% (92/198) of acute liver failure cases) of all acute onset icteric illness, with significant morbidity and mortality. As per seroprevalence data, 16.2% of children between 10–18 years of age, and 10.3% of adults aged 18–30 years remained susceptible to HAV infection.

Conclusion

HAV infection is the major contributor the overall pediatric liver disease burden. A significant proportion of subjects remain susceptible to HAV infection even after 10 years of age. Population-based studies are required to further delineate the epidemiology of HAV infection in India for deciding introduction of HAV vaccine in the national immunization schedule.

Keywords

Acute viral hepatitis Hepatitis A infection Seroprevalence rate Vaccination 

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Notes

Funding: None.

References

  1. 1.
    Yachha SK, Goel A, Khanna V, Poddar U, Srivastava A, Singh U. Ascitic form of sporadic acute viral hepatitis in children: A distinct entity for recognition. J Pediatr Gastroenterol Nutr. 2010;50:184–7.CrossRefGoogle Scholar
  2. 2.
    Alam S, Khanna R, Sood V, Lal BB, Rawat D. Profile and outcome of first 109 cases of paediatric acute liver failure at a specialized paediatric liver unit in India. Liver Int. 2017;37:1508–14.CrossRefGoogle Scholar
  3. 3.
    Alam S, Lal BB, Sood V, Rawat D. Pediatric acute-on-chronic liver failure in a specialized liver unit: Prevalence, profile, outcome and predictive factors. J Pediatr Gastroenterol Nutr. 2016;63:400–5.CrossRefGoogle Scholar
  4. 4.
    Aggarwal R, Goel A. Hepatitis A: epidemiology in resource-poor countries. Curr Opin Infect Dis. 2015;28:488–96.CrossRefGoogle Scholar
  5. 5.
    Squires RH Jr, Shneider BL, Bucuvalas J, Alonso E, Sokol RJ, Narkewicz MR et al. Acute liver failure in children: the first 348 patients in the pediatric acute liver failure study group. J Pediatr. 2006;148:652–658.CrossRefGoogle Scholar
  6. 6.
    Sarin SK, Choudhury A, Sharma MK, Maiwall R, Al Mahtab M, Rahman S, et al; APASL ACLF Research Consortium (AARC) for APASL ACLF working Party. Acute-on-chronic Liver Failure: Consensus Recommendations of the Asian Pacific Association for the Study of the Liver (APASL): An Update. Hepatol Int. 2019 Jun 6. [Epub ahead of print]Google Scholar
  7. 7.
    Morbidity and Mortality Weekly Report (MMWR): Viral Hepatitis Surveillance—India, 2011–2013. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6428a3.htm. Accessed September 7, 2018.
  8. 8.
    WHO vaccine-preventable diseases: monitoring system. 2018 global summary. Available from: http://apps.who.int/immunization_monitoring/globalsummary/countries?countrycriteria%5Bcountry%5D%5B%5D=IND&commit=OK. Accessed September 9, 2018.
  9. 9.
    Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2095–128.CrossRefGoogle Scholar
  10. 10.
    Franco E, Meleleo C, Serino L, Sorbara D, Zaratti L. Hepatitis A: Epidemiology and prevention in developing countries. World J Hepatol. 2012;4:68–73.CrossRefGoogle Scholar
  11. 11.
    Gripenberga M, D’Corb NA, L’Azouc M, Marshd G, Druellesc S, Nealon J. Changing sero-epidemiology of hepatitis A in Asia-Pacific countries: A systematic review. Int J Infect Dis. 2018; 68:13–7.CrossRefGoogle Scholar
  12. 12.
    Arankalle V, Mitra M, Bhave S, Ghosh A, Balasubramanian S, Chatterjee S, et al. Changing epidemiology of hepatitis A virus in Indian children. Vaccine: Development and Therapy. 2014;4:7–13.Google Scholar
  13. 13.
    Yao G. Clinical spectrum and natural history of viral hepatitis A in a 1988 Shanghai epidemic. In: Hollinger FB, Lemon SM, Margolis H, editors. Viral Hepatitis and Liver Disease: Proceedings of the 1990 International Symposium. Baltimore, MD: Williams and Wilkins; 1991. p. 76 80.Google Scholar
  14. 14.
    Arankalle VA, Sarada Devi KL, Lole KS, Shenoy KT, Verma V, Haneephabi M. Molecular characterization of hepatitis A virus from a large outbreak from Kerala, India. Indian J Med Res. 2006;123:760–9.PubMedGoogle Scholar
  15. 15.
    Rakesh P, Sherin D, Sankar H, Shaji M, Subhagan S, Salila S. Investigating a community-wide outbreak of hepatitis A in India. J Glob Infect Dis. 2014;6:59–64.CrossRefGoogle Scholar
  16. 16.
    Vizzotti C, González J, Gentile A, Rearte A, Ramonet M, Cañero-Velasco MC, et al. Impact of the single-dose immunization strategy against hepatitis A in Argentina. Pediatr Infect Dis J. 2014;33:84–8.CrossRefGoogle Scholar
  17. 17.
    Vizzotti C, Pippo T, Uruena A, Altuna J, Palópoli G, Hernández ML, et al. Economic analysis of the singledose immunization strategy against hepatitis A in Argentina. Vaccine. 2015;33:A227–32.CrossRefGoogle Scholar
  18. 18.
    Dagan R, Leventhal A, Anis E, Slater P, Ashur Y, Shouval D. Incidence of hepatitis A in Israel following universal immunization of toddlers. JAMA. 2005;294:202–10.CrossRefGoogle Scholar
  19. 19.
    Chironna M, Prato R, Sallustio A, Martinelli D, Tafuri S, Quarto M, et al. Hepatitis A in Puglia (South Italy) after 10 years of universal vaccination: need for strict monitoring and catch-up vaccination. BMC Infect Dis. 2012; 12:271.CrossRefGoogle Scholar
  20. 20.
    Cui F, Hadler SC, Zheng H, Wang F, Zhenhua W, Yuansheng H, et al. Hepatitis A surveillance and vaccine use in China from 1990 through 2007. J Epidemiol. 2009;19:189–95.CrossRefGoogle Scholar
  21. 21.
    Suwantika AA, Yegenoglu S, Riewpaiboon A, Tu HA, Postma MJ. Economic evaluations of hepatitis A vaccination in middle income countries. Expert Rev Vacc. 2013;12:1479–94.CrossRefGoogle Scholar
  22. 22.
    No authors listed. WHO position paper on hepatitis A vaccines - June 2012. Wkly Epidemiol Rec. 2012;87:261-76.Google Scholar

Copyright information

© Indian Academy of Pediatrics 2019

Authors and Affiliations

  • Vikrant Sood
    • 1
  • Bikrant Bihari Lal
    • 1
  • Ekta Gupta
    • 2
  • Rajeev Khanna
    • 1
  • Manish K. Siloliya
    • 1
  • Seema Alam
    • 1
    Email author
  1. 1.Department of Pediatric HepatologyInstitute of Liver and Biliary SciencesVasant Kunj, New DelhiIndia
  2. 2.Department of Clinical VirologyInstitute of Liver and Biliary SciencesVasant Kunj, New DelhiIndia

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