Hepatitis virus infection in children with chronic liver disease

Abstract

Background: Hepatitis B and Hepatitis C viral infections are important causes of chronic liver disease (CLD) in patients. Prevalence of hepatitis virus infections among children with chronic liver disease is not known from this region. Objectives: To know the prevalence of HBV,HCV,HAV and HEV infection among children of CLD attending Nehru Hospital, PGIMER, Chandigarh. Methods: Two hundred and seventy children (174 males and 96 females, mean age ± SD: 6.38 yrs ± 3.92) of CLD between July 2008 to December 2012 were included in the study. Patient features, routine investigations including abdominal USG were recorded. 2 ml blood was collected and serum samples were stored at -20°C.These were tested for HBsAg, anti HCV, anti HAV IgM and anti HEV IgM by ELISA. All samples were uniformly tested for these four parameters using same standards. Results: One hundred and sixty five patients (61.1%) out of 270 children with CLD were non-reactive for HBsAg, anti HCV, anti HAV IgM and anti HEV IgM. These patients were of EHPVO with or without ascites, auto-immune hepatitis and Wilson's disease.73 patients (27.03%) of CLD were reactive for HBsAg including 4 patients with HAV co-infection (anti HAV IgM reactive). Seventeen patients (6.29%) of CLD had HCV infection including one with HAV co-infection. 16 patients (5.92%) of CLD had HAV infection whilst 3 patients (1.11%) of CLD were suffering from HEV infection. Conclusion: Approximately 27% children with chronic liver disease were having hepatitis B infection followed by 6.29% children with HCV infection. Approximately 6% children of CLD had Hepatitis A infection and 1.1% children had acquired Hepatitis E infection through feco-oral route. Prophylactic vaccination against HBV and HAV infection needs to be intensified in children with chronic liver disease.