A Study on Clinical Sprectrum of Hepatitis A in Children Referred to Tertiary Care Hospital
Keywords:Acute viral hepatitis, Clinical spectrum, Hepatitis A (HAV).
Background and Aim: Acute viral hepatitis in children is a severe public health issue in developing counties like Pakistan. The hepatitis mostly found in the form of Hepatitis A among children. Hepatitis A clinical presentation and outcome needs to be signified by changing epidemiology of the disease among children. The aim of the present study was to investigate the clinical spectrum of hepatitis A among children referred to a tertiary care hospital.
Methodology: A cross-sectional study was carried out on 150 patients with acute viral hepatitis (AVH) signs and symptoms in the Department of Pediatric Medicine, Niazi Welfare Teaching Hospital, Sargodha from January 2022 to June 2022. The AVH signs and symptoms included anorexia, abdominal pain, bleeding manifestation, vomiting, nausea, jaundice, and tender hepatomegaly. Demographic
details such as gender, socioeconomic status, and age, Laboratory examinations, and clinical features were recorded on pre-designed proforma. Enzyme-linked immunosorbent assay (ELISA) was used for HEV IgM and HAV IgM evaluation from venous blood. Data analysis was carried out in SPSS version 25.
Results: Out of 150 AVH patients, the prevalence of hepatitis A (HAV) was 116 (77.3%). The overall mean age was 5.73 ± 4.21 years with an age range of 1 to 16 years. Age-wise distribution of the children were as follows; 64 (42.6%) in 1-5 years, 58 (38.7%) 6-10 years, and 28 (18.7%) 11-16 years. The median of disease duration was 7 days with range from 2 days to 3 weeks. The incidence of different signs and
symptoms such as fever, abdominal pain, dark-colored urine, vomiting, and anorexia 143 (95.3%), 116 (77.3%), 96 (64%), 68 (45.3%), and 92 (61.3%) respectively. Patients were distributed based on serum total bilirubin level, serum glutamate oxaloacetate transaminase (SGOT) level [normal range 5-40 IU/d], SGPT: serum glutamate pyruvate transaminase [normal range 7-56 IU/dL], ultrasound examinations, and complete blood count. Alanine aminotransferase (ALT) was significantly lower in HAV infection children [1695.7±897.5 IU/L] (p=0.03). Conclusion: The present study reported that prevalence of hepatitis A was 77.3% among children. Acute hepatitis A was more common in male children under 10 years of age with lower socioeconomic status and utilizing underground drinking water. There were slight differences between biochemical and clinical features of HEV and HAV. Fever was the most predominant symptoms followed by abdominal pain, darkcolored urine, vomiting, and anorexia.