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Acute Viral Hepatitis in Pediatric Age Groups
Sudhamshu Kc1, Dilip Sharma1, Nandu Poudyal1
1Liver Unit, Department of Medicine, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal, 2Department of Medicine, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal.
Insights
Hepatitis A is the most common cause of acute viral hepatitis in children in Kathmandu. Factors like herbal medication use and bacterial infections can prolong illness, suggesting early antibiotic treatment for certain cases.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Infectious Diseases
Background:
- Acute viral hepatitis remains a significant concern in pediatric populations, with no observed decrease in cases in Kathmandu.
- Understanding the specific etiological agents and clinical presentations is crucial for effective management.
Purpose of the Study:
- To analyze the etiology, clinical features, laboratory parameters, and sonological findings of acute viral hepatitis in children.
- To identify prognostic factors influencing the duration and severity of illness in pediatric patients.
Main Methods:
- A consecutive series of pediatric patients (<15 years) with suspected acute viral hepatitis were studied from 2006-2010.
- Patients underwent clinical examination, blood tests, and abdominal ultrasound, with data analyzed across three age groups (0-5, 5-10, 5-15 years).
Main Results:
- Hepatitis A virus (HAV) was the predominant etiology (85%), followed by Hepatitis E virus (HEV) (8%) and Hepatitis B virus (HBV) (5%).
- Ascites was more frequent in the 5-10 year age group. Secondary bacterial infections, prominent biliary radicals on ultrasound, and ascites correlated with longer illness duration.
- History of herbal medication use was associated with prolonged cholestasis.
Conclusions:
- Hepatitis A is the leading cause of acute viral hepatitis in the pediatric population studied.
- Improper herbal medication use, secondary bacterial infections, and poor diet contribute to prolonged illness.
- Prompt antibiotic treatment for prominent biliary radicals, even with normal blood counts, may expedite recovery.
Introduction:
Our clinical experience showed that there has been no decrease in pediatric cases of acute viral hepatitis in Kathmandu. The objective of the study was to analyze the etiology, clinical features, laboratory parameters, sonological findings and other to determine the probable prognostic factors of Acute Viral Hepatitis in pediatric population.
Methods:
Consecutive patients of suspected Acute Viral Hepatitis, below the age of 15 years, attending the liver clinic between January 2006 and December 2010 were studied. After clinical examination they were subjected to blood tests and ultrasound examination of abdomen. The patients were divided in 3 age groups; 0-5, 5-10 and 5-15 years. Clinical features, laboratory parameters, ultrasound findings were compared in three age groups.
Results:
Etiology of Acute Viral Hepatitis was Hepatitis A virus 266 (85%), Hepatitis E virus in 24 (8%), Hepatitis B virus in 15 (5%). In 7(2%) patients etiology was unknown. Three patients went to acute liver failure but improved with conservative treatment. There was no statistical difference in most of the parameters studied in different age groups. Ascites was more common in 5-10 years age group. Patients with secondary bacterial infection, ultrasound evidence of prominent biliary tree and ascites were associated with increased duration of illness. Patients with history of herbal medications had prolonged cholestasis.
Conclusions:
Hepatitis A is most common cause of Acute Viral Hepatitis in pediatric population. Improper use of herbal medications, secondary bacterial infection and faulty dietary intake was associated with prolonged illness. Patients with prominent biliary radicals should be treated with antibiotics even with normal blood counts for earlier recovery.
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