Evidence of hepatitis A virus infection in the patients with acute encephalitis syndrome in Gorakhpur region, North India

Abstract

The etiological agent remained unidentified in a large number of patients hospitalized for acute encephalitis syndrome (AES) in 2008-2009 in Uttar Pradesh and Bihar, north India. All patients were found to present with fever and altered sensorium, while 28%, 19% and 13% showed hepatomegaly, splenomegaly and meningeal signs, respectively. Involvement mostly of children with abnormal hepatic features prompted us to undertake an exploratory study on viral hepatitis A to determine its association, if any, with hepatic derangements. AES patients (n = 2515) and healthy children (n = 167) were investigated for the presence of serum anti-hepatitis A virus (anti-HAV) IgM and anti-Japanese encephalitis (anti-JE) virus IgM by ELISA. Cerebrospinal fluids (CSFs, n = 595) and rectal swabs (n = 182) were examined for anti-HAV IgM and/or HAV RNA. Anti-HAV IgM was detected in the sera of 14.6% patients as against 6.6% of healthy children (p = 0.0042). Anti-JE virus IgM positivity was Keywords: acute encephalitis syndrome; cerebrospinal fluid; hepatitis A virus; anti-HAV IgM; non-Japanese encephalitis.

Childhood encephalitis in the Greater Mekong region (the SouthEast Asia Encephalitis Project): a multicentre prospective study

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Clinical effect of spleen aminopeptide on improving liver function damage and immune function in children with infant hepatitis syndrome

“…The pathogenesis of IHS is complex, and in infancy, the development and progression of liver lesions are associated with interactions between various types of cells in the liver[ 8 ]. Hepatocytes, blood sinusoidal endothelial cells, bile duct epithelial cells, blastocytes, and lipid storage cells of the liver can interact and interfere with each other, either directly or through some cytokines[ 9 ].…”

Recent advances in hepatitis A virus research and clinical practice guidelines for hepatitis A virus infection in Japan

“…158 Meningoencephalitis was also reported to be associated with HAV infection. [159][160][161] Other extrahepatic features associated with HAV infection Cardiomyopathy and myocarditis following HAV infection were also reported. [162][163][164] Uveitis, arthritis, and acute pancreatitis may also be associated with HAV infection.…”

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