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Acute hepatitis A is the chief etiology of acute hepatitis in Egyptian children: a single-center study

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Abstract

Acute hepatic illness is an important health issue in children. Our work aimed to determine the prevalence of viral hepatitis in symptomatic children. It is a prospective cohort study of 268 children presented with acute hepatitis. Complete blood count, liver panel, and anti-hepatitis A virus (HAV) IgM were done initially. Cases negative for HAV were tested for anti-hepatitis E (HEV) IgM, anti-Epstein-Barr virus viral capsid antigen (EBV VCA) IgM, anti-cytomegalovirus virus IgM, hepatitis B surface antigen, anti-hepatitis B core IgM antibody, and anti-HCV antibody. Anti-HCV was repeated after 12 weeks to exclude seroconversion. In cases with negative viral serology, ceruloplasmin, total immunoglobulin G, antinuclear antibody, and abdominal ultrasound were done. Follow-up visits were bimonthly till recovery, then after 6 months. The mean age ± SD was 7.1 ± 3.7 years (1.5–18), and 56% were males. Acute HAV infection was diagnosed in 260 (97%) of cases and acute EBV infection in one case (0.4%). HAV/HEV coinfection was excluded in 70 HAV-positive cases. Six (2.2%) children remain undiagnosed and one child lost follow-up. About 80% of HAV-cases had normal laboratory results within 45 days. Unusual presentation of HAV infection was noticed in six children: four (1.5%) were relapsing, one had a cholestatic course, and one case had severe hemolytic anemia. Acute HAV infection was the chief etiology of acute hepatitis in our Egyptian children. The majority of the presentations were mild and children recover within a few weeks. An unusual pattern of HAV in children can be observed in endemic areas.

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Acknowledgments

I would like to thank all the Pediatric team at NHTMRI, in particular, Dr. Hany Abd Elaziz, for their continuous support and dedicated work.

Funding

This work was funded by the National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.

Author information

Authors and Affiliations

  1. Pediatric Department, Faculty of Medicine, Helwan University, Cairo, Egypt

    Hanan M. Fouad

  2. Departments of Clinical and Chemical Pathology, National Hepatology and Tropical Medicine Research Institute “NHTMRI”, Cairo, Egypt

    Ehab M. Reyad

  3. Departments of Clinical Chemistry, National Hepatology and Tropical Medicine Research Institute “NHTMRI”, Cairo, Egypt

    Amany Gmal El-Din

Authors
  1. Hanan M. Fouad
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  2. Ehab M. Reyad
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  3. Amany Gmal El-Din
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Contributions

Hanan Mina Fouad: idea, clinical follow up of children, collection of data, and writing draft of manuscript.

Ehab Mahfouz Read: biochemical analysis and approved the final manuscript.

Amany Gmal El-Din: biochemical analysis and approved the final manuscript.

Corresponding author

Correspondence to Hanan M. Fouad.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by the corresponding ethical committee.

Informed consent

Informed consent was obtained from one of the parents.

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Fouad, H.M., Reyad, E.M. & El-Din, A.G. Acute hepatitis A is the chief etiology of acute hepatitis in Egyptian children: a single-center study. Eur J Clin Microbiol Infect Dis 37, 1941–1947 (2018). https://doi.org/10.1007/s10096-018-3329-0

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  • DOI: https://doi.org/10.1007/s10096-018-3329-0

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