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Clinical presentation of hepatitis D in Pakistani children

Zaigham Abbas1, Ghous B Soomro, Syed M Hassan

  • 1Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.

European Journal of Gastroenterology & Hepatology
|August 5, 2014
PubMed

Insights

Hepatitis D virus (HDV) infection in children presents with more severe liver disease compared to hepatitis B virus (HBV) monoinfection. This aggressive presentation in HDV-infected children occurs regardless of hepatitis B e antigen (HBeAg) status.

Area of Science:

  • Hepatology
  • Pediatric Infectious Diseases
  • Virology

Background:

  • Limited data exist on hepatitis D virus (HDV) infection in pediatric populations.
  • Hepatitis D poses a significant global health challenge, often exacerbating hepatitis B virus (HBV) infections.

Purpose of the Study:

  • To investigate the clinical presentation and disease severity of HDV infection in children.
  • To compare the clinical outcomes of HDV infection with HBV monoinfection in a pediatric cohort.

Main Methods:

  • A comparative study involving pediatric patients (age ≤18 years) with chronic HDV infection (n=48) and HBV monoinfection (n=48).
  • Assessment included clinical evaluation, laboratory markers (ALT, AST, GGT, INR, platelet count), and liver biopsy in a subset of patients (n=50).
  • HDV RNA, HBV DNA, and HBeAg status were analyzed in the HDV cohort.

Main Results:

  • Children with HDV infection exhibited significantly more severe liver disease, including higher rates of cirrhosis, splenomegaly, and esophageal varices compared to HBV monoinfection.
  • Elevated liver enzymes (ALT, AST, GGT), altered coagulation (INR), and lower platelet counts were prominent in the HDV group.
  • While 50% of HDV patients had detectable HBV DNA and 52% were HBeAg positive, disease severity did not differ based on HBeAg status. Six HDV patients presented with decompensation.

Conclusions:

  • Pediatric HDV infection is associated with more aggressive liver disease progression than HBV monoinfection.
  • The severity of liver disease in children with HDV is independent of their hepatitis B e antigen (HBeAg) status.
  • HDV infection significantly increases the risk of advanced liver disease and complications in children.
Abstract

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