HomeLifestyleHealth & FitnessAlmost 93% Of Pediatric Hepatitis Cases Found To Share A Common Factor

Almost 93% Of Pediatric Hepatitis Cases Found To Share A Common Factor

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This is what hepatitis Needs to replicate in the liver, according to a new study

A recent study conducted by UC San Francisco sheds light on the origins of a concerning surge in acute severe hepatitis cases among healthy children following the relaxation of COVID-19 lockdowns in 35 countries, including the United States, in 2022.

Pediatric hepatitis is an uncommon disease, and the unexplained outbreak of severe hepatitis had prompted concern among doctors. So far, there have been around 1,000 reported cases, with 50 of them requiring liver transplants and at least 22 leading to fatalities.

According to the research published today in Nature, the disease has been associated with the simultaneous co-infections of multiple common viruses, especially adeno-associated virus type 2 (AAV2), which typically doesn’t cause hepatitis by itself. AAVs need the help of other viruses, such as adenoviruses, that cause colds and flus, to replicate in the liver.

The study suggests that after returning to school, children became more prone to common pathogen infections. Moreover, researchers found that a small subset of these children may have become more susceptible to severe hepatitis by contracting multiple infections at once.

“We were surprised by the fact that the infections we detected in these children were caused not by an unusual, emerging virus, but by common childhood viral pathogens,” comments senior author Charles Chiu.

“That’s what led us to speculate that the timing of the outbreak was probably related to the really unusual situations we were going through with COVID-19 related school and daycare closures and social restrictions,” Chiu adds. “It may have been an unintended consequence of what we have experienced during the last two-to-three years of the pandemic.”

By August 2022, there were reported clusters of cases in 35 countries, with 358 cases under investigation in the United States. The Centers for Disease Control and Prevention (CDC) initiated an investigation into the root causes of the outbreak.

For the study, which was supported by the CDC, researchers utilized polymerase chain reaction (PCR) and a range of metagenomic sequencing and molecular-testing methods to scrutinize plasma, whole blood, nasal swab, and stool samples from 16 pediatric cases in six states (Alabama, California, Florida, Illinois, North Carolina, and South Dakota) between Oct. 1, 2021, and May 22, 2022. The samples were compared to 113 control samples.

Upon genotyping the 14 available blood samples, the researchers found adeno-associated virus 2 (AAV2) in 93% of the cases and human adenoviruses (HAdVs) in all the cases. They also discovered that a specific adenovirus type associated with gastroenteritis (HAdV-41) was present in 11 cases. Furthermore, 85.7% of the cases featured additional co-infections with Epstein-Barr, herpes, and enterovirus.

Chiu highlighted that the outcomes of the study were consistent with two concurrent studies carried out in the United Kingdom, which found the same AAV2 strain. All three studies discovered co-infections from multiple viruses, and in the U.S. study, 75% of the children had contracted three or four viral infections.

While AAVs are not pathogenic by themselves, a direct causal link between the severe acute hepatitis and AAV has yet to be confirmed. Nevertheless, the study indicates that co-infections could lead to more severe hepatitis, and children may be more vulnerable to such outcomes. Though infections from adeno-associated viruses can occur at any age, the highest incidence rate is usually observed among children aged between 1 and 5, with the median age of affected children being three years old.

Although clusters of acute severe hepatitis in children have recently reduced, Chiu recommended frequent hand-washing and staying home when sick as the best measures to prevent such a rare outcome.

Image Credit: unsplash

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