TY - JOUR
T1 - The Outbreak of Unexplained Acute Hepatitis in Children
T2 - The Role of Viral Infections in View of the COVID-19 Pandemic
AU - Shteyer, Eyal
AU - Mor, Orna
AU - Waisbourd-Zinman, Orith
AU - Mozer-Glazberg, Yael
AU - Arnon, Ronen
AU - Hecht Sagie, Lior
AU - Mandelboim, Michal
AU - Erster, Oran
AU - Weil, Merav
AU - Dovrat, Sara
AU - Goldberg, Lital
AU - Gozlan, Yael
N1 - Publisher Copyright:
© 2024 by the authors.
PY - 2024/5
Y1 - 2024/5
N2 - 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.
AB - 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.
KW - COVID-19
KW - acute hepatitis of unknown origin
KW - human herpes virus 6
UR - http://www.scopus.com/inward/record.url?scp=85194219071&partnerID=8YFLogxK
U2 - 10.3390/v16050808
DO - 10.3390/v16050808
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C2 - 38793689
AN - SCOPUS:85194219071
SN - 1999-4915
VL - 16
JO - Viruses
JF - Viruses
IS - 5
M1 - 808
ER -