Hepatotropic viruses as etiological agents of acute liver failure and related-outcomes among children in India: a retrospective hospital-based study

BMC Research Notes

Yan Fang Liu⁴  Sanjoy Datta²  Gunasekaran Ramakrishnan⁵  Shailesh Mehta³  Ashish Bavdekar¹  Leni Grace Mathew⁶  Anand Pandit¹ 

[1] Department of Pediatrics and Neonatology, King Edward Memorial Hospital, Sardar Mudaliar Road, Rasta Peth, Pune 411011, India;GlaxoSmithKline Vaccines, Rue Fleming 20, Wavre, 1300, Belgium;GlaxoSmithKline Pharmaceuticals, Dr. Annie Besant Road, Worli, Mumbai 400 030, India;GlaxoSmithKline Vaccines, 150 Beach Road, #22-00 Gateway West, Singapore 189720, Singapore;GlaxoSmithKline Pharmaceuticals, #5 Embassy Links, SRT road, Bangalore 560052, India;Christian Medical College, Vellore Child Health Unit 1, Vellore 632004, India

关键词: India;    Hepatitis A;    Etiology;    Children;    Acute liver failure;   

Others  :  1230458
DOI  :  10.1186/s13104-015-1353-z

 received in 2014-01-07, accepted in 2015-08-17,  发布年份 2015

【 摘 要 】

Background

Acute liver failure (ALF) is marked by a sudden loss of hepatic function and is associated with a high mortality rate in children. The etiology of ALF is shown to vary geographically. This study assessed the frequency of hepatotropic viruses as etiological agents of ALF in Indian children.

Methods

This retrospective study enrolled children aged 0–18 years with confirmed ALF admitted to Christian Medical College, Vellore and King Edward Memorial Hospital and Research Center, Pune between January 2003 and December 2005. The frequency of hepatotropic viruses as etiological agents in children with ALF aged ≤18 years was calculated with 95 % confidence interval (CI). Descriptive analyses of demographic characteristics, clinical signs and symptoms of ALF, choice of treatment and outcomes were performed.

Results

Of 76 children enrolled, 54 were included in the per-protocol analyses. Mean age of children with ALF was 5.43 years (standard deviation = 3.62); 51.9 % (28/54) were female. The percentage of children positive for anti-hepatitis A virus (HAV) IgM and hepatitis B surface antigen was 65.9 % (27/41; 95 % CI 49.4–79.9) and 15.9 % (7/44; 95 % CI 6.6–30.1), respectively. The final cause of ALF was HAV (36.3 %) followed by hepatitis B virus (HBV; 8.8 %). Before and during admission, encephalopathy was observed in 77.8 % (42/54) and 63.0 % (34/54) of children, respectively. A high number of children (46/54; 85.2 %) required intensive care and ALF was fatal in 24.1 % (13/54). The proportion of deaths due to HAV and HBV was 18.5 % (5/27) and 57.1 % (4/7), respectively.

Conclusions

HAV and HBV were the most common etiological agents of ALF in Indian children. Primary prevention by vaccination against HAV and HBV in young children may be useful in the prevention of ALF due to viral hepatitis in India.

【 授权许可】

   
2015 Pandit et al.

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