Authors
1
Baghdad Teaching Hospital, Medical City, Baghdad, Iraq
2
Children Teaching Hospital, Medical City, Baghdad, Iraq
,
Document Type : Research Paper
Abstract
BACKGROUND:
Hepatitis A virus is a small spherical non‐enveloped virus classified under the family Picornaviridae . It is highly contagious. Transmission is by person to-person contact through the fecal–oral route. Poor sanitation and personal hygiene, and consumption of contaminated food and water, are the commonest causes of HAV transmission. It is a viral liver disease that has a clinical spectrum ranges from asymptomatic infection to fulminant hepatitis and hepatic encephalopathy which is possibly reversible with treatment. The implementation of routine vaccination of children seems, in the long term, the most reasonable way to get recurrent outbreaks under control.
AIM OF THE STUDY:
To evaluate the clinical and laboratory findings in HAV infection in patients with and without encephalopathy.
METHOD:
It was A prospective hospital based study was done from March 2018 to July 2019 carried out in the Children Welfare Teaching Hospital in Baghdad included 59 patients whom admitted, all were diagnosed as acute hepatitis A infection as defined by the presence of anti- hepatitis A immunoglobulin M. The clinical data collected by history taking and clinical examination, biochemical and imaging data collected in questionnaire papers for each patient, then all data gathered in an Excel table and statistical analysis done.
RESULTS:
A total number of 59 patients were admitted to Children Welfare Teaching Hospital diagnosed as hepatitis A infection, included in our study, 27 ( 45.7% ) Male, 8 ( 29.6 % ) of them had encephalopathy, and 32 ( 54%) were female,11 ( 34.3% ) of them had encephalopathy. the study had showed that the statistically significant factors for hepatic encephalopathy were PTT, INR, bleeding and ascites .
CONCLUSION:
The present study has concluded that the rate of hepatic encephalopathy among patients with hepatitis A infection is relatively high, the abnormality in coagulation profile, the presence of bleeding tendency and ascites were statistically important factors in the development of encephalopathy in patients with hepatitis A infection, most affected children were between 5 and 10 years old, patients living outside of Baghdad had higher rates of encephalopathy.
- Mona Abdel‐Hady1and C. Y. William Tong2, Viral Hepatitis , Diseases of the Liver and Biliary System in Children, Fourth Edition Set in 10/12 pt Minion by SPi Global, Pondicherry, India , 2017:191-93 .
- Morse LJ, Bryan JA, Hurley JP, Murphy J, O’Brien TF, Wacker WEC. The Holy Cross College football team hepatitis outbreak. J Am Med Assoc 1972;219:706–8.
- Koff RS. Hepatitis A. Lancet. 1998;351:1643–49.
- World Hepatitis Day: WHO releases mind-boggling figures Sunday , July 28, 2019 8:25 am | News
- Noele P. Nelson, M.D., P.h.D, M.P.H. and Trudy V. Murphy, M.D. Hepatitis A: the changig epidemiology of hepatitis A, Cli Liver Dis (Hoboken), 2013 ;2:227-30.
- Cash WJ, McConville P, McDermott E, McCormick PA, Callender ME, McDougall NI , Current concepts in the assessment and treatment of hepatic encephalopathy ,QJM . 2010;103:9-16.
- Ferenci P, Lockwood A, Mullen K, Tarter R, Weissenborn K, Blei AT. Hepatic encephalopathy—definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology. 2002; 35: 716-21.
8. Vilstrup H, Amodio P, Bajaj J, Cordoba J, Ferenci P, Mullen KD, Weissenborn K, Wong P. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014; 60:715-35.
9. Elisabetta Franco, Cristina Meleleo, [...], and Laura Zaratti , Hepatitis A: Epidemiology and prevention in developing countries, World J Hepatol. 2012; 4: 68–73.
- Paolo Bonnani, Sara Boccalini, Angela Bechini, Vaccination against hepatitis A in children, Therapeutics and Clinical Risk Management 2007;3: 1071–76.
- Jeong S, Lee H. Hepatitis A: clinical manifestations and management. Intervirology 2010;53:15–19.
- Kyle Jensen and William F. Balistreri , Viral Hepatitis , NELSON TEXTBOOK OF PEDIATRICS, TWENTEETH EDITION , Elsevier Inc. , Canada , 2016: 1942-45.
- Biostatistics: A Foundation for Analysis in the Health Sciences. Wayne W Daniel & Chad L Cross; 10th. John Wiley & Sons Inc, USA, 2013.
- Biostatistics: Basic Concepts & Methodology for the Health Sciences. WW Daniel; 9th John Wiley & Sons Inc. 2010.
- Zhifang Wang, Yaping Chen, Shuyun Xie, Huakun Lv, Changing Epidemiological Characteristics of Hepatitis A in Zhejiang Province, China: Increased Susceptibility in Adults, PLOS /ONE Crops ,Food Security and Food Systems Channel , April 2016 , DOI:10.1371/journal.pone.0153804
- Uzma Shah, Zehra Habib, Liver Failure Attributable to Hepatitis A Virus Infection in a Developing Country, Pediatrics 2000;105;436.
17. Seyed Mohsen Dehghani, Seyed Hamdollah Mosavat, Mohammad Reza Bordbar, Risk Factors of Mortality in Children with Hepatic Encephalopathy, Journal of Pediatric Sciences ,2013;5;e191.
18. Hyun Woong Lee, Dong-Yeop Chang, Hong Ju Moon, et al , Clinical Factors and Viral Load Influencing Severity of Acute Hepatitis A, PLOS | ONE , June 2015 , DOI:10.1371/journal.pone.0130728.
- Abidullah Khan, Maimoona Ayub, and Wazir Mohammad Khan , Hyperammonemia Is Associated with Increasing Severity of Both Liver Cirrhosis and Hepatic Encephalopathy , International Journal of Hepatology, Volume 2016, Article ID 6741754, 5 pages.
- Rajesh Kumar Meena1, Sundarmurthy G2, Pushpa Saravanan1, Karthik P1, Karthika Ramadoss1, Vivekanandan A1, Serum Zinc Level in Decompensated Liver Disease and its Correlation with Stage of Hepatic Encephalopathy, Journal of association of physicians in India , 2019;67 .
- Maurya V, Ravikumar R, Gopinath M, Ram B. Ultrasound in acute viral hepatitis: Does it have any role?. Med J DY Patil Vidyapeeth 2019;12:335-39.
-
- Gürkan, Ascitis and Pleural Effusion Accompanying Hepatitis A Infection in a Child, Clinical Microbiology and Infection, December 2001; 6, Issue 5.
)
