Dengue virus infection: a major cause of acute hepatic failure in Thai children.

Ann Trop Paediatr

Center of Excellence in Viral Hepatitis Research, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University and Hospital, Bangkok, Thailand.

Published: March 2006

AI Article Synopsis

  • A study on acute hepatic failure (AHF) in Thai children aged 1-15 identified various causes, with dengue infection being the most common, accounting for 34.3% of cases.
  • The study involved testing serum samples for different viruses and found a total of 40 subjects, with 68.6% fatality rate, including 33.3% of deaths linked to dengue.
  • The findings suggest that improved sanitation and the hepatitis B vaccination program contribute to reducing AHF cases from hepatitis A and B, while dengue remains a significant concern.

Article Abstract

Background: Acute hepatic failure (AHF) can be caused by a variety of viruses, drugs, toxins and metabolic disorders.

Aims: A prospective study was conducted to determine the aetiology and outcome of AHF in Thai children aged 1-15 years.

Methods: All serum samples were tested for anti-HAV IgM, HBsAg, anti-HBc IgM, anti-HCV, anti-HEV IgM and anti-dengue IgG and IgM. Further individual investigations were done according to the clinical impression.

Results: Forty subjects were enrolled from 14 centres during February 2000 to December 2001. Five cases were excluded owing to a lack of evidence of encephalopathy. The causes of AHF were dengue infection in 12 (34.3%), Wilson disease in 2 (5.7%), T-cell lymphoma in 2 (5.7%), ischaemic hepatitis in two (5.7%), haemophagocytic syndrome in one (2.8%), CMV in 2 (5.7%), Reye syndrome in one (2.8%) and unknown in 13 (37.1%) patients. The fatality rate was 68.6%. Eight of 24 (33.3%) deaths were caused by dengue infection.

Conclusions: Improvements in sanitation and socio-economic status as well as the implementation of hepatitis B vaccine in the Extended Programme on Immunization (EPI) are likely to be the reasons for the observed absence of AHF caused by hepatitis A and B. The study showed that dengue infection, on the other hand, was a major cause of AHF in Thailand.

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Source
http://dx.doi.org/10.1179/146532806X90565DOI Listing

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