Rotavirus Hepatitis in Pediatric Hematopoietic Stem Cell Transplant Recipients
Gabriella Kertész1, Zsófia Szkiba1, Katalin Csordás1
1From the Department of Pediatric Hematology and Stem Cell Transplantation.
Insights
Rotavirus infection causes more severe liver injury in children after stem cell transplant (TX) compared to healthy children (ROTA). This suggests rotavirus may target the liver in immunocompromised patients.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Transplant Medicine
Background:
- Rotavirus is a leading cause of gastroenteritis in children.
- Stem cell transplantation (TX) can alter a child's immune system and susceptibility to infections.
- Hepatic involvement during rotavirus infection is not well-characterized in transplant recipients.
Purpose of the Study:
- To compare hepatic biomarker changes during rotavirus infection between stem cell transplant recipients and healthy children.
- To investigate temporal changes in liver function markers before, during, and after rotavirus infection in transplant recipients.
Main Methods:
- Retrospective analysis of rotavirus-infected children, including allogeneic stem cell transplant recipients (TX group) and healthy children (ROTA group).
- Collected demographic, transplant, and laboratory data, including liver function tests (ASAT, ALAT, GGT, ALP, bilirubin, albumin).
- Analyzed serum levels of liver biomarkers and disease outcomes before, during, and after rotavirus infection.
Main Results:
- TX group showed significantly higher ASAT, ALAT, total bilirubin, and conjugated bilirubin compared to the ROTA group.
- Lower albumin and globulin levels were observed in the TX group.
- The TX group experienced a longer disease duration, with significant temporal changes in ASAT, GGT, and ALP levels.
Conclusions:
- Children undergoing hematopoietic stem cell transplantation exhibit more pronounced liver injury during rotavirus infection.
- The findings suggest a potential hepatotropic behavior of rotavirus in the context of stem cell transplantation.
- Close monitoring of liver function is recommended for transplant recipients during rotavirus infection.
Background:
Rotavirus infection is the most common cause of gastroenteritis in children. In our study, we investigated whether changes in hepatic biomarkers measured during rotavirus infection were significantly different between stem cell transplant recipients and the normal population, before, during and after infection.
Methods:
Rotavirus-infected children who had previously undergone allogeneic stem cell transplantation and rotavirus-infected otherwise healthy children were included. Data were collected retrospectively, including demographic, transplant and laboratory parameters as well as disease outcome measures. We analyzed the aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total bilirubin, conjugated bilirubin, albumin and immunoglobulin G serum levels in the TX group before, during and after the rotavirus infection.
Results:
In the TX versus ROTA group, we found a significantly higher value in the following parameters: ASAT, ALAT, total bilirubin and conjugated bilirubin. Significantly lower albumin and globulin levels were observed in the TX group than in the ROTA group. Furthermore, a significantly longer disease duration was observed in the TX group. In the TX group, significant difference was found comparing the ASAT, GGT and ALP levels before, during and after rotavirus infection.
Conclusions:
Based on our data, more pronounced liver involvement can be observed during rotavirus infection in children undergoing hematopoietic stem cell transplantation; therefore, a possible hepatotropic behavior of the virus may be postulated in this setting.
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