Epidemiology and outcome of severe hepatitis A infection in children in Kuwait

ABSTRACT

To describe the epidemiology, clinical features and outcome of hepatitis A virus [HAV] infection in children in Kuwait. The medical records of 350 patients [age 0-16 years] admitted to the Infectious Diseases Hospital, Kuwait, between January 2000 and December 2002, with hepatitis A infection were reviewed. The mean age was 8.6 +/- 3.8 years and 47% of patients were between 7 and 12 years old. Kuwaiti children comprised 44% of admitted patients. The largest proportion of children with hepatitis A [34%] were from the northern part of the country. HAV infection was prevalent throughout the year with a peak during the months of August to October. Of the Kuwaiti children, 31% reported a history of contact with jaundiced patients, while 52% of the non-Kuwaiti children had a history of recent travel prior to their illness. Patients had symptoms for a mean of 6 +/- 3.6 days prior to presentation. The mean length of hospitalization was 5.8 +/- 2.9 days. The rate of complications of HAV infection was 6% and only one child required admission to the intensive care unit for fulminant hepatitis. None of the patients had permanent sequelae. HAV infection is a significant cause of morbidity for children in Kuwait. The disease is mostly prevalent in preschool and school age children. Despite the excellent outcome of all patients, a considerable number of patients tend to have a complicated course and prolonged hospitalization. In view of these data, hepatitis A vaccine should be considered as a part of routine childhood immunization in Kuwait