Frequency of Hepatitis A virus as a cause of anicteric hepatitis in children under 5 years: a common yet under-recognized cause

Background: Hepatitis A is the most common form of acute viral hepatitis in developing countries. In children < 6 years of age, most infections are asymptomatic, and if illness does occur, it is usually anicteric. This study aimed to determine the frequency of HAV in Egyptian children under 5 years presenting with gastroenteritis-like manifestations and to associate the frequency of HAV with social, demographic, and various risk factors. Results: Among 450 children aged from 6 months to 5 years of both sexes, presenting with gastroenteritis-like manifestations and anicteric hepatitis, 200/450 children had elevated transaminases (ALT, AST) and were recruited in the study. A total number of 24 (12%) out of 200 children were found to have HAV IgM antibodies. Lower maternal and paternal education, poor sanitary and hygienic conditions, crowding, contaminated water, and lack of sanitary facilities were significantly higher in HAV-positive group (p-value < 0.05). ALT and AST were significantly higher in HAV IgM-positive group (p-value < 0.01). Conclusion: HAV infection is common in Egyptian children with gastroenteritis-like manifestations and anicteric hepatitis. Hepatitis A is a vaccine-preventable disease.

Automated summary

This study found that hepatitis A infection is common in Egyptian children under 5 years old with gastroenteritis-like manifestations and anicteric hepatitis. Some social, demographic, and hygienic factors may be associated with the occurrence of hepatitis A.