Clinical Spectrum of Hepatitis A Infection in Infants

The Hepatitis A virus (HAV) is a prevalent contagious illness transmitted through the feco-oral route––particularly endemic in rapidly urbanizing areas. Despite the availability of effective vaccines, inadequate sanitation perpetuates its persistence.

The aim of a study was to examine the clinical characteristics of Hepatitis A infection in children.

In this retrospective analysis, cases of acute HAV diagnosed by IgM hep A were investigated among children aged 6 months to 12 years over the past year at a tertiary care hospital. Clinical features and complications were assessed.

This study enrolled 27 cases, with a mean age of 6.5 ± 3.9 years. The most common presenting symptoms were fever in 92.6%, gastrointestinal complaints in 59.3%, and lethargy in 37%. Irritability and altered sensorium were observed in 44.4% of the patients. Physical examination revealed hepatomegaly in 96.2% and jaundice in 100%. Nearly all cases showed a significant increase in aspartate transaminase (AST) and alanine transaminase (ALT) levels, with 44.4% demonstrating deranged prothrombin time and 27% showing elevated serum ammonia. However, 27% of the cases to fulminant hepatic failure – 2 cases with dengue co-infection, one case associated with nimesulide consumption, and one case with chronic liver disease. There were 25.9% fatalities, whereas 74.1% fully recovered.

From the results, it was concluded that although Hepatitis A infection typically resolves spontaneously, severe complications can arise in the presence of co-infection, underlying liver conditions, or certain medication use. Therefore, close monitoring of all cases until complete recovery is essential.

Source: Bhargava A, Panchal S, Gavhane J. J of the Pedia Ass India. 2019;8(3):1-2.