Global Advanced Research Journal of Medicine and Medical Sciences (GARJMMS) ISSN: 2315-5159
August 2013 Vol. 2(8), pp. 184-189
Copyright © 2013 Global Advanced Research Journals

Full Length Research Paper

Factors predicting fulminant course of acute Hepatitis A with special emphasis on predictors of mortality in Egyptian children

Wesam Saber Morad^1*, Yasser Rashed², and Alif A. Allam²

¹Community Medicine and Public Health, National Liver Institute, Menoufiya University.
²Pediatric Hepatology, National Liver Institute, Menoufiya University.

*Corresponding Author E-mail: wesammorad@yahoo.com; Mobile: +201009066238 

Accepted 20 August, 2013

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). 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. 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). 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.

Keywords: Hepatitis A virus; fulminant hepatitis; fecal- oral transmission; Risk factors; low socioeconomic level.