Frequency of Anicteric Hepatitis A Virus Infection in a Group of Pre-School Egyptian Children Presenting with Gastroenteritis like Manifestations

Abstract

Abstract Background Hepatitis A virus (HAV) infection is one of the most frequent communicable diseases with an estimated 1.5 million cases diagnosed each year globally. Most infections in children under the age of six are asymptomatic and if infection occurs, it is usually anicteric. Therefore, the disease is underreported. Aim To determine the prevalence of HAV infection in a group of Pre-School Egyptian children presenting with gastroenteritis like manifestations and anicteric-hepatitis and to correlate that with social and demographic risk factors. Patients and Methods This was a cross sectional study conducted at Ain Shams University Children’s hospital emergency room and outpatient clinic, Cairo, Egypt during the period from February 2023 to July 2023 and performed on 385 preschool Egyptian child presented with acute gastroenteritis like manifestations; who were jaundice free, with no past history of HAV infection, HAV vaccination or chronic liver disease. To all enrolled cases, history was taken, clinical examination done, socioeconomic status and liver enzymes assessed, HAV IgM antibody was evaluated only in group with elevated liver enzymes double upper limit of normal for age and sex and for cases with positive HAV IgM, complete blood count and international normalized ratio (INR) withdrawn to assess severity of the disease. Results Among the enrolled cases, only 32 cases had elevated liver enzymes (8.3%), 4 cases had positive HAV IgM (1%) with no stastical difference between males and females. Poor hand hygiene was significantly higher in group with elevated liver enzymes compared to other studied cases. Lower score in family possessions in socioeconomic evaluation was significant in the group with positive HAV IgM in comparison to the remained studied population. Conclusion Frequency of anicteric HAV infection is not uncommon in preschool age group with gastroenteritis like manifestations. Hand hygiene and family possessions can influence its prevalence. Hepatomegaly, right hypochondrial tenderness and certain cut values of transaminases may be used as good NPV values in diagnosis of HAV infection.