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.
Abstract

Related Concept Videos

Hepatitis01:25

Hepatitis

Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver.
34
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
369
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
327
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
693
Viral Meningitis01:18

Viral Meningitis

Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
32
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
458