Clinical and Biochemical Profile of Hepatitis A Virus infection in Children

ABSTRACT

Background: Acute hepatitis A virus infection in children in developing countries is a matter of concern though the incidence has come down in developed countries.To observe the clinical presentation and biochemical profile of hepatitis A virus infection in children hospitalized in a tertiary care center in Bangladesh.Material & Methods:In this cross-sectional observational study, data were collected from the records of pediatric patients who were admitted due to acute hepatitis. Demographic data were collected, and complete physical examination findings and laboratory data were also taken. Serum samples were tested for LFT, Anti-HAV IgM and other viral markers among them Anti-HAV IgM positive children were included in the study.Results:Among the total of 40 patients suffering from Acute Viral Hepatitis (AVH), male predominated over female with 57.5% vs. 42.5%. The majority of the study population (65%) came from the urban area. In this study, 65% of the patients used tap water and 35% used tube well water for drinking purposes while the majority 70% used boiled water. Most of the patients (80%) consumed both homemade and outside foods and drinks while 20% consumed only homemade food. Positive family history of viral hepatitis was found in 12.5% of cases. Common presentations were fever (100%), jaundice (100%), anorexia, nausea (95%), vomiting (85%), abdominal pain (50%) etc. On examination Jaundice (100%) and hepatomegaly (95%), splenomegaly (5%), and ascites (7.5%). Only 7.5% of patients developed complications like cholestasis,7.5% showed ascites,5% had relapsed and 2.5% develop liver failure.Conclusions:This study showed that poor sanitation and poor hygiene are the main risk factors for hepatitis A. The common presenting features which should alert the clinicians include fever, jaundice, anorexia, nausea, vomiting, diarrhea, abdominal distension, hepatosplenomegaly and ascites. In Bangladesh, safe water supplies and proper sanitation will constitute the best solution to eliminate endemic hepatitis A.