What question did this study set out to answer?

To investigate the epidemiological characteristics and identify potential infectious etiologies of an unexplained surge in acute severe pediatric hepatitis in the UK.

September 26, 2023The Lancet Child & Adolescent HealthOpen Access

Paediatric acute hepatitis of unknown aetiology: a national investigation and adenoviraemia case-control study in the UK

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Authors

SMSema MandalNational Institute for Health and Care Excellence RSRuth SimmonsNational Security Agency GIGeorgina IrelandInstitute of Child Health

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Implication

Case-control study demonstrates a strong association between adenovirus 41F viremia and acute severe hepatitis in children, indicating a primary viral driver of the unexplained outbreak.

Key Points

To investigate the epidemiological characteristics and identify potential infectious etiologies of an unexplained surge in acute severe pediatric hepatitis in the UK.
Conducted national active surveillance of unexplained pediatric acute hepatitis (transaminase >500 IU/L) in UK children under 16 years presenting between Jan 1 and July 4, 2022 (N=274).
Performed a case-control study using multivariable Firth penalized logistic regression in children aged 1–10 years to examine associations between adenoviremia and hepatitis status compared to frequency-matched hospital controls.
Assessed temporal correlations with routine laboratory viral surveillance via linear regression and evaluated SARS-CoV-2 seropositivity against matched clinical comparison groups.
Adenovirus was identified in 68% (172/252) of tested cases overall and in 63% (137/218) of blood samples, with adenovirus type 41F (Ad41F) confirmed in 81% (58/72) of genotyped cases; 15 (5%) children required liver transplantation and none died.
Adenoviremia was strongly associated with hepatitis case status in the case-control analysis (adjusted OR 37.4 [95% CI 15.5–90.3]).
Increases in routine fecal adenovirus detection correlated with acute hepatitis presentations 4 weeks later (β 0.06 [95% CI 0.02–0.11]), whereas SARS-CoV-2 antibody seropositivity demonstrated no association.

Cite This Study

Mandal et al. (2023) studied this question.

synapsesocial.com/papers/6a7f3288729ee4a9f084ea98 https://doi.org/10.1016/s2352-4642(23)00215-8

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Implication

Case-control study demonstrates a strong association between adenovirus 41F viremia and acute severe hepatitis in children, indicating a primary viral driver of the unexplained outbreak.

Paediatric acute hepatitis of unknown aetiology: a national investigation and adenoviraemia case-control study in the UK

Discussion

Member takes

Implication

Key Points

Cite This Study

Paediatric acute hepatitis of unknown aetiology: a national investigation and adenoviraemia case-control study in the UK

Discussion

Member takes

Implication

Key Points

Cite This Study

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