Factors predicting fulminant course of acute Hepatitis A with special emphasis on predictors of mortality in Egyptian children.
Journal Title: Journal of Medical Science And clinical Research - Year 2013, Vol 1, Issue 2
Abstract
Hepatitis A virus (HAV), a non enveloped RNA virus, is particularly resistant and contagious. The infection is spread chiefly by fecal- oral transmission and is a public health problem throughout the world. The main complication of HAV infection is fulminant hepatitis (FH). Methods: this study was done on 80 children, 50 with acute hepatitis A virus and 30 developed fulminant hepatic failure, 52 males and 28 females. In fulminant group 12 recovered with normal liver function, but 18 were died. Children recovered from fulminant liver failure had encephalopathy grade 1 or 2. Results: The study showed statistically significant differences between acute hepatitis A virus and low socioeconomic level and bad hygiene ( P < 0.004), children received anti convulsive therapy P < 0.009 and also with diabetic children P < 0.004. Total bilirubin > 9.56, Direct bilirubin > 5.11, ALT > 1365.7, AST > 1635.78, Prothrombin time prolonged more than 25.87 seconds are indices for increasing the risk for developing fulminant hepatic failure in children with acute HAV( P <0.000001, P <0.00001, P < 0.00001, P < 0.0001, P <0.00001 respectively). Mortallity rates was statistically significant related to prolonged prothrombin time, decreased ALT and AST, elevation of serum bilirubin and blood urea and serum creatinine and also with high grade of coma (grade 3 and 4).Conclusion: This study emphasize that early prediction of FHF can be predicted by simple tests and appropriate medical treatment could block further liver destruction and prevent development of FHF.
Authors and Affiliations
Wesam Saber Morad
Keywords
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