Demystifying the global outbreak of severe acute hepatitis of unknown aetiology in children: A systematic review and meta-analysis

Phan, Julie; Eslick, Guy D.; Elliott, Elizabeth J.

doi:10.1016/j.jinf.2023.11.011

Cited by 6 publications

(1 citation statement)

References 36 publications

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“…Altered susceptibility and response to such pathogens may be a consequence of immunological naivety following pandemic restrictions. The need for further investigations on the etiology of different patient demographics and geographical areas is highlighted [9].…”

Section: Introductionmentioning

confidence: 99%

The Outbreak of Unexplained Acute Hepatitis in Children: The Role of Viral Infections in View of the COVID-19 Pandemic

Shteyer,

Mor,

Waisbourd-Zinman

et al. 2024

Viruses

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Background and Aims: An increase in the number of cases of acute hepatitis of unknown origin (HUO) in children was observed in 2021. Adenovirus and adeno-associated virus 2 (AAV2) infections have been suggested as possible triggers. However, the potential etiology is still unclear. We aimed to characterize a cohort of children with HUO in Israel in view of the COVID-19 pandemic. Method: Demographics, clinical data, and laboratory results on the children compatible with the CDC criteria for HUO were collected by the established registry of the Ministry of Health. Available specimens were sent to the Central Virology Laboratory. Results: A total of 39 children were included in the registry. A total of 20 were enrolled prospectively, in which human herpes virus 6 (HHV6) infection or reactivation was identified in 11/19, adenovirus was found in 4/19 of the cases, and AAV2 was detected in 2/16. Past COVID-19 exposure was recorded for 24/39 of the children. A total of 10 children underwent liver biopsy, and 8 were successfully treated with steroids and 2 underwent liver transplantation. Conclusions: The COVID-19 pandemic and the related containment measures combined with reactivation or active infection with other viruses could have been a trigger for the HUO outbreak. In our cohort, HHV6 was the most abundant finding.

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Section: Introductionmentioning

confidence: 99%