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Acute infectious hepatitis in hospitalised children: a British Paediatric Surveillance Unit study.

Braccio, S; Irwin, A; Riordan, A; Shingadia, D; Kelly, DA; Bansal, S; Ramsay, M; Ladhani, SN (2017) Acute infectious hepatitis in hospitalised children: a British Paediatric Surveillance Unit study. Arch Dis Child, 102 (7). pp. 624-628. ISSN 1468-2044 https://doi.org/10.1136/archdischild-2016-311916
SGUL Authors: Ladhani, Shamez Nizarali

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Abstract

BACKGROUND: Hepatitis remains a key public health priority globally. Most childhood cases are caused by viruses, especially hepatitis A virus (HAV) and hepatitis B virus (HBV). This study aimed to estimate the burden of acute infectious hepatitis in hospitalised children and to describe their clinical characteristics and outcomes. METHODS: Paediatricians in the UK and Ireland reported cases in children aged 1 month to 14 years diagnosed between January 2014 and January 2015 (inclusive) through the British Paediatric Surveillance Unit (BPSU) and completed a detailed questionnaire. Additional HAV and HBV cases in England and Wales were identified through a national electronic database, LabBase2. All confirmed cases were followed up at 6 months with a second questionnaire. RESULTS: The BPSU survey identified 69 children (annual incidence, 0.52/100 000), including 27 HAV (39%), three HBV (4%), 16 other viruses (23%) and 23 with no aetiology identified (33%). LabBase2 identified an additional 10 HAV and 2 HBV cases in England. Of the 37 hospitalised HAV cases, 70% had travelled abroad, but only 8% had been vaccinated. Similarly, three of the five children with acute HBV had not been immunised, despite being a household contact of a known infectious individual. All patients with HAV recovered uneventfully. In contrast, three children with acute HBV developed liver failure and two required liver transplantation. CONCLUSIONS: Acute infectious hepatitis is a rare cause of hospital admission. Most children recovered without complications, but those with acute HBV had severe presentations. At least three of the five HBV cases could have been prevented through appopriate vaccination of household contacts.

Item Type: Article
Additional Information: This article has been accepted for publication in Archives of Disease in Childhood following peer review. The definitive copyedited, typeset version Braccio S, Irwin A, Riordan A, et al Acute infectious hepatitis in hospitalised children: a British Paediatric Surveillance Unit study Archives of Disease in Childhood 2017;102:624-628. is available online at: http://dx.doi.org/10.1136/archdischild-2016-311916
Keywords: British Paediatric Surveillance Unit (BPSU), child, hepatitis, vaccine, Acute Disease, Adolescent, Child, Child, Hospitalized, Child, Preschool, Hepatitis A, Hepatitis B, Humans, Incidence, Infant, Ireland, Prognosis, Prospective Studies, Risk Factors, Travel, United Kingdom, British Paediatric Surveillance Unit (BPSU), child, hepatitis, vaccine, Acute Disease, Adolescent, Child, Child, Hospitalized, Child, Preschool, Hepatitis A, Hepatitis B, Humans, Incidence, Infant, Ireland, Prognosis, Prospective Studies, Risk Factors, Travel, United Kingdom, Pediatrics, 1103 Clinical Sciences, 1114 Paediatrics And Reproductive Medicine, 1117 Public Health And Health Services
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Arch Dis Child
ISSN: 1468-2044
Language: eng
Dates:
DateEvent
1 July 2017Published
4 April 2017Published Online
29 January 2017Accepted
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
UNSPECIFIEDGlaxoSmithKlinehttp://dx.doi.org/10.13039/100004330
PubMed ID: 28377449
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/109174
Publisher's version: https://doi.org/10.1136/archdischild-2016-311916

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