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Abnormal liver function in children hospitalized with acute respiratory infection of adenoviruses: a retrospective

Xingui Tian1, Xiao Li1, Shuyan Qiu1

  • 1State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510182, China.

Virologica Sinica
|August 3, 2023
PubMed

Insights

Human adenovirus (HAdV) infections in children can lead to abnormal liver function tests. Specific types, HAdV-7 and HAdV-55, may be significant contributors to pediatric hepatitis.

Area of Science:

  • Pediatric Infectious Diseases
  • Hepatology
  • Virology

Background:

  • Human adenoviruses (HAdVs) are known causes of acute hepatitis in immunocompromised individuals.
  • The role of HAdVs in hepatitis among immunocompetent children remains unclear.
  • Acute respiratory infections are common in children and can be caused by HAdVs.

Purpose of the Study:

  • To investigate the association between adenovirus infection and liver function abnormalities in hospitalized children.
  • To identify specific HAdV types that may contribute to hepatitis in pediatric patients.
  • To analyze liver function test (LFT) patterns in children with HAdV infections.

Main Methods:

  • Retrospective analysis of LFT results in children (age < 14 years) hospitalized for HAdV-related acute respiratory infections between January 2016 and October 2019.
  • Categorization of patients based on HAdV type (HAdV-7, HAdV-55, HAdV-3, etc.).
  • Comparison of LFT parameters (ALT, AST, γ-GT, albumin, bilirubin) between different HAdV infection groups and analysis of serial LFTs in a subset of patients.

Main Results:

  • Elevated alanine transaminase (ALT) and aspartate aminotransferase (AST) levels were observed in 7.74% and 46.89% of patients, respectively.
  • HAdV-7 and HAdV-55 infections were associated with significantly elevated ALT or AST levels (> 2-fold upper limit of normal).
  • HAdV-7 infection group showed higher ALT, AST, and γ-GT, and lower albumin levels compared to HAdV-3 group. HAdV-55 infection was linked to higher γ-GT, total bilirubin, and direct bilirubin.

Conclusions:

  • Adenovirus infection frequently correlates with abnormal liver function in children.
  • HAdV-7 and HAdV-55 are potential, under-recognized causes of hepatitis in immunocompetent children.
  • Persistent LFT abnormalities were noted during hospitalization in severe cases, highlighting the clinical significance of HAdV-associated liver injury.

Keywords:
Acute respiratory diseaseAdenovirusHepatitisLiver enzymeLiver function test

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