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[Clinical features of hepatitis A in 1,629 children]
Shi-shu Zhu1, Hong-fei Zhang, Xiao-jin Yang
1Department of Pediatric Liver Diseases, The 302nd Hospital of PLA, Beijing 100039, China.
Insights
This study analyzed 1,629 children with hepatitis A, finding no significant changes in age or disease duration over time. Hepatitis B virus (HBV) coinfection was linked to prolonged illness in pediatric hepatitis A cases.
Area of Science:
- Hepatology
- Pediatric Infectious Diseases
- Virology
Context:
- Hepatitis A virus (HAV) infection is a significant public health concern in children.
- Understanding the clinical spectrum and epidemiological trends of HAV is crucial for effective management.
- This study retrospectively analyzed a large cohort of pediatric patients over two decades.
Purpose:
- To investigate the clinical features and trends of hepatitis A in children under 14 years.
- To compare clinical data between two distinct treatment periods (1984-1990 and 1991-2000).
- To identify factors influencing disease course and potential co-infections.
Summary:
- A total of 1,629 children with hepatitis A were analyzed, divided into two groups based on treatment period.
- No significant differences in average age or disease duration were observed between the two groups.
- Hepatitis B virus (HBV) coinfection was identified as the major viral co-infection, significantly prolonging the disease course.
- Elevated and multi-peak serum alanine aminotransferase (ALT) levels were noted, potentially linked to liver damage and immune responses.
- Piecemeal necrosis was observed in a small subset of patients, not indicative of chronicity.
Impact:
- Provides insights into the long-term clinical characteristics of pediatric hepatitis A.
- Highlights the role of HBV coinfection in exacerbating HAV disease severity and duration.
- Informs clinical practice regarding the diagnosis and management of hepatitis A in children, especially in endemic areas.
Background:
To investigate the clinical features of hepatitis A in 1 629 children under 14 years of age treated in our department at various periods of time.
Methods:
The patients were divided into two groups: 1. Group A consisted of 883 patients treated from January 1984 to December 1990; 2. Group B consisted of 746 patients treated from January 1991 to December 2000. The clinical data of all the patients were retrospectively analyzed.
Results:
1. The average age was 7.17+/-3.27 and 8.78+/- 3.28 years (chi2=0.54, P>0.05) and the mean course of disease 26.25+/-16.96 and 25.65+/-12.58 days (chi2=0.29, P>0.05). 2. Double peak or multi-peak serum ALT was found in 89 patients. Four peaks of serum ALT was found in one patient. 3. HBsAg was found positive in 143 patients (8.80%). The mean course of disease was 34.40+/-25.86 and 25.20+/-15.43 days (chi2=146.5, P<0.001) in HBsAg positive and negative patients, respectively. 4. Liver puncture biopsy in 26 patients with hepatitis A showed that there was piecemeal necrosis in 2 patients.
Conclusions:
1. There was no significant delay in age of children with HAV infection in 1990s. There was no marked difference in the course of disease between the patients simultaneously receiving various drugs and those receiving one or two drugs. 2. The double peak or multi-peak of serum ALT in patients with hepatitis A might be related to liver damage caused by HAV and immune mechanism. 3. The major type of virus for combined infection in patients with hepatitis A is HBV. The course of disease was prolonged with combined infection of HBV. 4. Piecemeal necrosis might be seen in the liver of a small proportion of patients with hepatitis A alone, which may not be enough to suggest chronicity.