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Case report: psychosis associated with hepatitis B

H C Weber1, J F Schoeman, A Nowitz

  • 1Department of Paediatrics and Child Health, University of Stellenbosch, Faculty of Medicine, Tygerberg, South Africa.

Journal of Medical Virology
|September 1, 1994
PubMed
Summary

Hepatitis B virus (HBV) infection in a child was linked to a rare brain disorder. Researchers detected HBV DNA in cerebrospinal fluid, indicating a potential central nervous system infection.

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Area of Science:

  • Neurology
  • Virology
  • Pediatrics

Background:

  • Hepatitis B virus (HBV) infection is a significant global health concern, primarily affecting the liver.
  • Disintegrative disorders in children are rare and often have complex etiologies.
  • The potential neurological impact of acute HBV infection, especially in pediatric cases, remains incompletely understood.

Observation:

  • A pediatric case presented with symptoms suggestive of an acute disintegrative disorder.
  • The child was diagnosed with acute hepatitis B virus (HBV) infection.
  • Cerebrospinal fluid (CSF) analysis revealed the presence of hepatitis B surface antigen (HBsAg) and HBV DNA.

Findings:

  • Enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) confirmed HBsAg and HBV DNA in the CSF.

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  • Elevated adenylate kinase (AK) levels in the CSF normalized with spontaneous recovery, suggesting an organic brain disorder.
  • Intra-blood-brain barrier IgG production indicated a localized HBV infection within the central nervous system.

    • Implications:

    • This case suggests a direct link between acute HBV infection and central nervous system (CNS) involvement in children.
    • The findings highlight the importance of considering neurological complications in pediatric HBV cases.
    • Further research is warranted to elucidate the mechanisms of HBV neuroinvasion and its long-term neurological consequences.